Relationship of the Asthma Control Test (ACT) with Lung Function, Levels of Exhaled Nitric Oxide and Control According to the Global Initiative for Asthma (GINA)

Álvarez-Gutiérrez, Francisco Javier; Medina-Gallardo, Juan Francisco; Pérez-Navarro, Pablo; Martín-Villasclaras, Juan José; Etchegoren, Bernardo Martin; Romero-Romero, Beatriz; Praena-Fernández, Juan Manuel

doi:10.1016/s1579-2129(10)70087-2

Cited by 40 publications

(35 citation statements)

References 18 publications

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“…14 In contrast, moderate to low correlations were observed between the ACT score and FEV 1 , F ENO , and specialists' rating of control according to NAEPP EPR-3 guidelines. 9,15,16 The substantially low correlations between the ACT scores and physiologic measures of asthma, such as FEV 1 values and F ENO , support the notion that asthma control cannot be inferred from physiologic measures alone. 14,17 Furthermore, the ACT has been validated in many languages [18][19][20][21][22][23] and in different settings, including in asthma specialist consultations, 9 in primary care, 13 in pharmacies, 24 by mail, 25 by speech-recognition telephone calls, 26 and over the internet.…”

Section: Validitymentioning

confidence: 89%

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Asthma Control Assessment Tools

Alzahrani

Becker

2015

Respir Care

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, and they emphasize periodic assessment of asthma control once treatment is established. Accurate assessment of asthma control is difficult due to the complexity of asthma control and due to the limitations in the traditional methods of assessment, such as lung function tests, physician assessment, and patients' self-assessment. Relying solely on the role of lung function tests is insufficient to reflect the status of asthma control, since patients with asthma may have normal spirometry between exacerbations. Clinicians often overestimate the level of asthma control. Similarly, it is not uncommon for patients to overestimate how well their asthma is controlled, and, therefore, they under-report asthma symptoms and fail to recognize the impact that asthma has on their daily life. As a result, several tools have been developed to quantify the level of asthma control, identify patients at risk, and evaluate the effect of asthma management. This review examines the commonly 106RESPIRATORY CARE • JANUARY 2016 VOL 61 NO 1 used asthma control assessment tools in terms of content, psychometric properties, methods of administration, limitations, and ability to reflect the overall status of asthma control, which can aid clinicians in selecting the most appropriate tool for their needs.

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Section: Validitymentioning

confidence: 89%

“…Alvarez-Gutiérrez et al 15 assessed the test-retest reliability of the ACT on subjects who remain stable at baseline and follow-up visits; they had the same specialist ratings of asthma control on both visits. The authors reported a test-retest reliability of 0.77.…”

Section: Reliabilitymentioning

confidence: 99%

Asthma Control Assessment Tools

Alzahrani

Becker

2015

Respir Care

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“…Algumas limitações poderão ser apontadas a este estudo nomeadamente a amostra ser de conveniência; a não exclusão das crianças asmáticas com características que poderiam afetar as medições do FENO, no entanto, a sua Melo B, et al Fração exalada de óxido nítrico em crianças asmáticas, Acta Med Port 2014 Jan-Feb;27(1): [59][60][61][62][63][64][65][66] não exclusão permite manter as conjunturas habituais da prática clínica e obter resultados que podem ser extrapolados para a população geral de crianças asmáticas e não só para o grupo de crianças asmáticas que não tivessem essas características 17 ; a variabilidade diurna do DEMI 59 e a possível má execução da técnica, na realização do exame, por parte da criança. Contudo, na ausência de instrumento de avaliação do controlo asma validado para população pediátrica em Portugal, decidiu-se avaliar os doentes segundo as linhas de orientação da GINA, que incluíam a medição do DEMI através do debitómetro.…”

Section: Discussionunclassified

“…11,[16][17][18][19][20][21][22] Um dos métodos que permite avaliar a inflamação das vias aéreas é a biópsia brônquica, contudo, este exame é caro e invasivo, não podendo ser repetido rotineiramente. 16,23 Outro método é a expetoração induzida, no entanto muitas crianças não conseguem expelir as secreções e a obtenção dos resultados é demorada.…”

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Fração Exalada de Óxido Nítrico no Controlo e Abordagem Terapêutica da Asma

et al. 2014

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(1) = 8,71; OR = 2,33; p = 0,003) sobre a probabilidade de mudar de nível de controlo da asma. Por cada nível de fração exalada de óxido nítrico incrementado o odds de passar a não controlada é 2,33 vezes superior. Discussão: A probabilidade de uma criança asmática mudar o seu nível de controlo da asma, de 'controlada' para 'parcialmente controlada/não controlada', tendo em consideração uma alteração no seu nível da fração exalada de óxido nítrico, aumenta 133%. Palavras-chave: Criança; Asma; Expiração; Óxido Nítrico; Portugal. AbSTRACTIntroduction: Asthma is a chronic respiratory disease characterized by hyper-responsiveness and bronchial inflammation. The bronchial inflammation in these patients can be monitored by measuring the fractional exhaled nitric oxide. This study aims to determine fractional exhaled nitric oxide association with peak expiratory flow and with asthma control inferred by the Global Initiative for Asthma. Material and Methods:Observational, analytical and cross-sectional study of children with asthma, 6-12 years-old, followed in the Outpatient Respiratory Pathology of Braga Hospital. Sociodemographic and clinical information were collected through a questionnaire. fractional exhaled nitric oxide and peak expiratory flow were determined by portable analyzer Niox Mino ® and flow meter, respectively. Results: The sample is constituted by 101 asthmatic children, 63 (62.4%) of males and 38 (37.6%) females. The mean age of participants in the sample is 9.18 (1.99) years. The logistic regression performed with the cutoff value obtained by ROC curve, revealed that fractional exhaled nitric oxide (b FENO classes = 0.85; χ 2 Wald (1) = 8.71; OR = 2.33; p = 0.003) has a statistical significant effect on the probability of changing level of asthma control. The odds ratio of going from "controlled" to "partly controlled/uncontrolled" is 2.33 per each level of fractional exhaled nitric oxide. Discussion: The probability of an asthmatic children change their level of asthma control, from 'controlled' to 'partly controlled/uncontrolled', taking into account a change in their fractional exhaled nitric oxide level, increases 133%.

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“…Al igual que en el estudio de Álvarez-Gutiérrez, encontramos que la mayoría de los pacientes, tanto en el grupo con asma controlada como no controlada, según GINA, estaba correctamente clasificada por el nivel de ACT. 31 Buzoianu et al 32 demostraron que el ACT guarda una correlación con la variación del pico flujo espiratorio en el seguimiento de los pacientes con asma y que dicha correlación no está influida por la edad de los pacientes ni por la presencia de rinitis alérgica, pero sí por el sobrepeso.…”

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Sensibilización IgE y las condiciones sociodemográficas como determinantes en la gravedad del asma

Gaviria

Ocampo

Londoño

et al. 2017

RAM

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Este artículo debe citarse como: Gaviria R, Ocampo J, Londoño J, Calvo V, Cardona R, Sánchez J. Sensibilización IgE y las condiciones sociodemográficas como determinantes en la gravedad del asma. AbstractBackground: In Latin America there are few data about the factors that influence the control and severity of asthma. Objective: To describe the association between IgE sensitization to intra-home allergens and housing conditions in the severity of asthma. Methods: Sensitization to aero-allergens was evaluated by skin prick test and socio-demographic data by a questionnaire in a population between 6 and 14 years of age with diagnosis of asthma. Asthma control was measured according to spirometric results and to the application of the ACT (Asthma Control Test); the severity and symptom control was evaluated according to the GINA guideline. Results: A total of 150 resident patients from the Aburra Valley (Colombia) were included. The median age of participants was 11 years, 95 (63.3 %) male. 92 % of the patients resided in the urban area. Mite sensitization was the most prevalent in controlled and uncontrolled patients. Sensitization to cockroach and some poverty conditions were risk factors for asthma severity. Conclusion: Poverty conditions appear to favor the development of severe asthma and in turn IgE sensitization to cockroaches. This sensitization could serve as a biomarker of severity.

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Relationship of the Asthma Control Test (ACT) with Lung Function, Levels of Exhaled Nitric Oxide and Control According to the Global Initiative for Asthma (GINA)

Cited by 40 publications

References 18 publications

Asthma Control Assessment Tools

Asthma Control Assessment Tools

Fração Exalada de Óxido Nítrico no Controlo e Abordagem Terapêutica da Asma

Sensibilización IgE y las condiciones sociodemográficas como determinantes en la gravedad del asma

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