Relationship between asthma control status, the Asthma Control Test™ and urgent health-care utilization in Asia

ABSTRACT Background and objective:  Accurate assessment of control is an integral part of asthma management. We investigated the relationship between control status derived from the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT) and urgent health‐care utilization. Methods:  Asthm...

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Published in:Respirology (Carlton, Vic.) Vic.), 2011-05, Vol.16 (4), p.688-697
Main Authors: LAI, CHRISTOPHER K.W., KO, FANNY W.S., BHOME, ARVIND, DE GUIA, TERESITA S., WONG, GARY W.K., ZAINUDIN, BIN M.Z., NANG, AN N., BOONSAWAT, WATCHARA, CHO, SANG H., GUNASEKERA, KIRTHI D., HONG, JIAN G., HSU, JENG-YUAN, VIET, NHUNG N., YUNUS, FAISAL, MUKHOPADHYAY, AMARTYA
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ambulatory Care - utilization
Asia
Asthma - diagnosis
Asthma - drug therapy
asthma control
Asthma Control Test
Child
Child, Preschool
community survey
Cross-Sectional Studies
Delivery of Health Care - utilization
exacerbation
Female
Global Initiative for Asthma
Health Care Surveys
Hospitalization
Humans
Male
Monitoring, Physiologic - methods
Severity of Illness Index
Surveys and Questionnaires
Treatment Outcome
urgent health-care utilization
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Summary:ABSTRACT Background and objective:  Accurate assessment of control is an integral part of asthma management. We investigated the relationship between control status derived from the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT) and urgent health‐care utilization. Methods:  Asthma Insights and Reality in Asia‐Pacific Phase 2 (AIRIAP 2) was a cross‐sectional, community‐based survey of 4805 subjects with asthma from urban centres across Asia. A symptom control index was derived from the AIRIAP 2 questionnaire using the GINA control criteria for day‐ and night‐time symptoms, need for rescue medication, activity limitation and exacerbations; lung function was excluded. The main outcomes were asthma control, based on these GINA criteria and the ACT, and the relationship between control and self‐reported urgent health‐care utilization (hospitalization, emergency room visits or other unscheduled urgent visits) related to asthma over the previous 12 months. Results:  Each of the symptom criteria was significantly associated with urgent health‐care utilization, with odds ratios (ORs) ranging from 2.25 (95% confidence interval (CI): 1.94–2.61) for daytime symptoms to 2.57 (95% CI: 2.29–2.90) for nocturnal awakening. Similarly, control status was significantly associated with urgent health‐care utilization, with ORs of 0.19 (95% CI: 0.13–0.28), 0.70 (95% CI: 0.65–0.76) and 1.00 for controlled, partly controlled and uncontrolled, respectively. The optimal ACT cut‐off score for identifying uncontrolled asthma was ≤19 for subjects aged ≥12 years. Urgent health‐care utilization was reported by 57.2% versus 28.7% of patients scoring ≤19 versus >19 (P 
ISSN:1323-7799
1440-1843
DOI:10.1111/j.1440-1843.2011.01954.x