Can the Asthma Control Questionnaire be used to differentiate between patients with controlled and uncontrolled asthma symptoms? A pilot study

Nieuwenhof, Lotte van den; Schermer, Tjard; Eysink, Petra E. D.; Halet, Eric; Weel, Chris van; Bindels, Patrick J E; Bottema, Ben

doi:10.1093/fampra/cml041

Cited by 33 publications

(34 citation statements)

References 20 publications

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“…In that study, the authors also found that the questionnaire discriminated well between patients with different degrees of symptom intensity and frequency. 18 In the present study, a positive relationship was also observed between scores on the CAN questionnaire and patient or carer overall perceptions of asthma control.…”

Section: Discussionsupporting

confidence: 72%

Development and validation of a questionnaire to assess asthma control in pediatrics

Pérez-Yarza

Badı́a²,

Badiola

et al. 2008

Pediatric Pulmonology

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on behalf of the CAN Investigator Group { Summary. Objective: To develop and validate a questionnaire to assess asthma control in children (CAN). Design: Two versions of the CAN (for carers and children) were developed. Both versions were validated in an observational, prospective, multicenter study performed in 38 hospital outpatient clinics throughout Spain. Four hundred fifteen patients and their carers agreed to participate. Of these, 414 patients under 14 years old with frequent episodic or persistent (moderate to severe) asthma completed the questionnaire on 3 occasions (baseline, week 2, and week 12). For patients aged 2-8 the questionnaire was only completed by the carers, but for patients aged 9-14 the questionnaire was completed by the carers and the children. Clinician ratings of asthma control were used as a gold standard to assess the sensitivity, specificity, PPV and NPV of the new measure. Results: Evaluable responses were obtained from 215 carers for children aged 2-8 years and 199 children aged 9-14 years, and their parents. Using a questionnaire total score cut-off of 8 the patient version had a sensitivity of 76.3% and a specificity of 62.9%. For carer version these values were 73% and 69.7%, respectively. A cut point of 8 was selected to maximize the screening accuracy of the CAN questionnaire. Effect sizes in patients with clinician-rated improvements in asthma control were 0.33 and 0.57 for the carer and child versions, respectively. Conclusions: The screening accuracy and validity of the CAN questionnaire make it suitable for use in research and clinical practice. The sensitivity and specificity were close to 70%, which is acceptable for the study objective: obtain a tool to measure the level of asthma control.

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Section: Discussionsupporting

confidence: 72%

Development and validation of a questionnaire to assess asthma control in pediatrics

Pérez-Yarza

Badı́a²,

Badiola

et al. 2008

Pediatric Pulmonology

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“…In a previously reported pilot study, 13 we established an ACQ cutoff value for identifying patients with asthma who have suboptimal control of their symptoms. A sum score of 3 points or less best indicated good asthma symptom control, having a sensitivity of 84% and a specifi city of 76%.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, 13 we found that the Asthma Control Questionnaire (ACQ) [14][15][16] can be used to distinguish asthma patients with good symptom control from those with suboptimal symptom control. The aim of the current study was to investigate whether a mailing of the ACQ can be used to trace asthma patients with suboptimal symptom control in the family practice population.…”

Section: S17mentioning

confidence: 99%

“…10 The requirement of laboratory facilities, the time-consuming nature of these tests, and their unfriendliness to patients severely hamper their routine use in primary care, however. An increase of asthma symptoms has been shown to indicate a loss of asthma control, 11,12 making measurement of changes in symptoms an attractive alternative to the above tests.In a previous study, 13 we found that the Asthma Control Questionnaire (ACQ) [14][15][16] can be used to distinguish asthma patients with good symptom control from those with suboptimal symptom control. The aim of the current study was to investigate whether a mailing of the ACQ can be used to trace asthma patients with suboptimal symptom control in the family practice population.…”

mentioning

confidence: 99%

“…When resources are limited, the goal might be to identify only patients with very poorly controlled asthma symptoms, and a higher ACQ cutoff might be more appropriate. 13 An interesting observation was that a substantial proportion of the visitors (65%) still had suboptimal symptom control. In fact, this proportion was even greater than that among the nonvisitors (43%).…”

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confidence: 99%

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Tracing Uncontrolled Asthma in Family Practice Using a Mailed Asthma Control Questionnaire

Nieuwenhof¹,

Schermer²,

Heins³

et al. 2008

The Annals of Family Medicine

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PURPOSE A substantial proportion of adult patients with asthma have inadequately controlled symptoms despite the availability of effective treatment. The Asthma Control Questionnaire (ACQ) can be used to discriminate between asthma patients with well-and suboptimally controlled asthma symptoms. The objective of this study was to investigate whether a postal mailing of the ACQ can be used to identify asthma patients with suboptimal symptom control in family practice. METHODSIn this observational study, we sent 434 asthma patients from 6 Dutch family practices an ACQ by mail to measure control of their asthma symptoms. Both respondents and nonrespondents were characterized by information gathered from their medical records. Patients with an ACQ sum score (total score) of greater than 3 were considered to have suboptimally controlled asthma symptoms. RESULTSThe response rate was 77%. Respondents were more likely than nonrespondents to be female and to use asthma medication. The mean ACQ sum score of the respondents was 5.2. Of this group, 53.4% (95% confi dence interval, 48.0%-58.8%) had suboptimally controlled asthma symptoms. Of the 168 respondents who had not visited their family physician in the 2 years before the study, 42.9% (95% confi dence interval, 35.4%-50.4%) had inadequate asthma symptom control. CONCLUSIONSOur results show that a postal mailing of the ACQ is an effective approach for tracing asthma patients who need medical attention. It also traces patients who would otherwise not have consulted their family physician. The ACQ seems to be a useful starting point for health care professionals in family practice to improve the level of asthma symptom control in their patient population.Ann Fam Med 2008;6(suppl 1):s16-s22. DOI: 10.1370/afm.776. INTRODUCTIONP opulation surveys have shown that despite the availability of highly effective pharmacotherapy, the majority (up to 70%-95%) of all asthma patients in western Europe and the Asia-Pacifi c region have signs of poor asthma control.1-3 Known causes of this suboptimal level of asthma control are poor adherence to periodic management visits to health care professionals [4][5][6] or insuffi cient compliance with prescribed asthma medication, especially inhaled corticosteroids. 5 In addition, patients with asthma-and their physicians-tend to overestimate their level of asthma control. 7,8 These factors emphasize the need to improve the identifi cation of poor asthma control and subsequent treatment. Because the majority of patients with asthma are treated by family physicians, family practice would be the most appropriate setting to study the tracing of patients with poor asthma control.Bronchial infl ammation is a marker of asthma control that can be assessed by induced sputum eosinophilia 9 or bronchial hyperrespon- S17T R ACING UNCONT ROL L ED A S T HM A siveness. 10 The requirement of laboratory facilities, the time-consuming nature of these tests, and their unfriendliness to patients severely hamper their routine use in primary care, however. ...

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Asthma control questionnaires in the management of asthma in children: A review

et al. 2014

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Several self-administered questionnaires have been developed to assess childhood asthma control in a simple and standardized way. This review discusses the most commonly used questionnaires and explores their usefulness in asthma management in children. We conclude that the use of asthma control questionnaires in daily practice and in research contributes to the standardized evaluation of children with asthma and helps to track asthma symptoms, but validation studies in a wider range of settings are needed.

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Can the Asthma Control Questionnaire be used to differentiate between patients with controlled and uncontrolled asthma symptoms? A pilot study

Cited by 33 publications

References 20 publications

Development and validation of a questionnaire to assess asthma control in pediatrics

Development and validation of a questionnaire to assess asthma control in pediatrics

Tracing Uncontrolled Asthma in Family Practice Using a Mailed Asthma Control Questionnaire

Asthma control questionnaires in the management of asthma in children: A review

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