Assessment of Asthma Control Using Asthma Control Test (ACT) and it Relationship with Lung Function Parameters

Abstract

Background: Bronchial Asthma is a disease with increasing global significance. Its prevalence is projected to increase to 400 million by the year 2025 as compared to the present estimate of 300 million. Previously asthma was assessed mainly in terms of symptoms and measures of lung functions but more recently these indices have not been able to reflect the true state of the asthmatics. The focus is now shifting to an assessment and treatment approach based on control. Asthma Control Test (ACT) is a validated, simple and inexpensive instrument to assess control among patients with bronchial asthma. However, its relationship with lung function parameters is yet to be demonstrated among Nigerian asthmatic patients. Aim: The study aimed at assessing asthma control using ACT scores and to determine its relationship with lung function parameters among persons with asthma in a university respiratory clinic. Methodology: It was a cross-sectional study. The study included 65 patients with bronchial asthma who underwent routine check-ups in respiratory clinics at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile-Ife, Nigeria between October 2009 and January 2011. The ACT was administered to assess for asthma control. Lung function test was done using the guidelines of American Thoracic Society (ATS). Results : The mean pre-bronchodilator FEV 1 was 1.97 ± 0.87L, mean ACT score was 18.2+4.28, 24 (37%) of the study subjects had well-controlled asthma. The ACT scores were weakly correlated with percentage of predicted Forced Expiratory Volume in 1 second, FEV 1(r=0.220, p=<0.078) and Peak Expiratory Flow, PEF(r=0.168, p= 0.18). Conclusion: In this study, most of the patients had poor asthma control and lung function parameters correlated poorly with Asthma Control Test (ACT) scores. It is important that the ACT complements other physiological measures of assessing asthma control in our environment.