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 12months. 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 ≥12years. Urgent health-care utilization was reported by 57.2% versus 28.7% of patients scoring ≤19 versus >19 (P<0.001). CONCLUSIONS: The GINA control classification and the ACT are valid symptom-based measures that are significantly associated with urgent health-care utilization.
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 12months. 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 ≥12years. Urgent health-care utilization was reported by 57.2% versus 28.7% of patients scoring ≤19 versus >19 (P<0.001). CONCLUSIONS: The GINA control classification and the ACT are valid symptom-based measures that are significantly associated with urgent health-care utilization.
Authors: Kam Lun Hon; Yan Min Bao; Kate C Chan; Kin Wai Chau; Rong-Shan Chen; Kun Tat Gary Cheok; Wa Keung Chiu; Li Deng; Chun-Hui He; Kin Mui Ieong; Jeng Sum C Kung; Ping Lam; Shu Yan David Lam; Qun Ui Lee; So Lun Lee; Ting Fan Leung; Theresa N H Leung; Lei Shi; Ka Ka Siu; Wei-Ping Tan; Maggie Haitian Wang; Tak Wai Wong; Bao-Jing Wu; Ada Y F Yip; Yue-Jie Zheng; Daniel K Ng Journal: World J Pediatr Date: 2018-07-25 Impact factor: 2.764
Authors: Ka Pang Chan; Fanny Wai San Ko; Kwun Cheung Ling; Pik Shan Cheung; Lee Veronica Chan; Yu Hong Chan; Yi Tat Lo; Chun Kong Ng; Macy Mei-Sze Lui; Kwok Sang Wilson Yee; Cee Zhung Steven Tseng; Pak Yiu Tse; Mo Lin Maureen Wong; Kah Lin Choo; Wai Kei Lam; Chun Man Wong; Sheng Sheng Ho; Chung Tat Lun; Christopher Kei Wai Lai Journal: Immun Inflamm Dis Date: 2021-03-03