BACKGROUND: Periodic measurement of disease control is recommended to characterize asthma and monitor treatment. OBJECTIVE: To elaborate and validate an asthma control score (ACS) for use in studies based on administrative health databases. METHODS: Adult patients with asthma were recruited from a clinic. The ACS is based on the average number of doses of short-acting inhaled beta(2)-agonists taken per week and short courses of oral corticosteroids dispensed over a three-month period. Data were obtained from the Régie de l'assurance maladie du Québec database in Canada. The ACS was compared with the asthma control questionnaire and the use of health care services for asthma over a 12-month period. RESULTS: A total of 60 patients were enrolled. They had a mean (+/- SD) age of 50.4+/-13.9 years, and 43.3% were male. Patients had had asthma for 20.8+/-15.1 years on average and had a mean prebronchodilator forced expiratory volume in 1 s of 77.0% of the predicted value. The mean ACS was 8.3+/-11.6, with a range of 0 to 60. The ACS was not found to be correlated with the asthma control questionnaire, but it was significantly associated with health care services used. For each additional point in the ACS, patients were 2% more likely to need acute care for asthma (rate ratio 1.02; P=0.02). CONCLUSIONS: Further studies including patients followed by general practitioners are required before the general use of this score. This innovative score is useful to rapidly assess the control of asthma over long periods of time and at a low cost in studies using administrative drug databases.
BACKGROUND: Periodic measurement of disease control is recommended to characterize asthma and monitor treatment. OBJECTIVE: To elaborate and validate an asthma control score (ACS) for use in studies based on administrative health databases. METHODS: Adult patients with asthma were recruited from a clinic. The ACS is based on the average number of doses of short-acting inhaled beta(2)-agonists taken per week and short courses of oral corticosteroids dispensed over a three-month period. Data were obtained from the Régie de l'assurance maladie du Québec database in Canada. The ACS was compared with the asthma control questionnaire and the use of health care services for asthma over a 12-month period. RESULTS: A total of 60 patients were enrolled. They had a mean (+/- SD) age of 50.4+/-13.9 years, and 43.3% were male. Patients had had asthma for 20.8+/-15.1 years on average and had a mean prebronchodilator forced expiratory volume in 1 s of 77.0% of the predicted value. The mean ACS was 8.3+/-11.6, with a range of 0 to 60. The ACS was not found to be correlated with the asthma control questionnaire, but it was significantly associated with health care services used. For each additional point in the ACS, patients were 2% more likely to need acute care for asthma (rate ratio 1.02; P=0.02). CONCLUSIONS: Further studies including patients followed by general practitioners are required before the general use of this score. This innovative score is useful to rapidly assess the control of asthma over long periods of time and at a low cost in studies using administrative drug databases.
Authors: W M Vollmer; L E Markson; E O'Connor; L L Sanocki; L Fitterman; M Berger; A S Buist Journal: Am J Respir Crit Care Med Date: 1999-11 Impact factor: 21.405