Abstract
BackgroundAchieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. The aim of this study is to evaluate the relationship between Asthma Control Test (ACTTM), Asthma Therapy Assessment Questionnaire (ATAQTM) and exercise-induced bronchospasm (EIB).MethodsWe studied 80 asthmatic children. Airways hyperresponsiveness (AHR) was assessed by exercise-induced bronchospasm (Balke Protocol). Asthma control was evaluated using two questionnaires in all subjects: ACT (composed by Childhood-ACT and ACT) and ATAQ. In addition the use of short acting beta 2 agonist agents (SABAs) was assessed for each patient. Non-parametric variables were compared by Chi Square Test. Binomial logistic regression was performed to estimate the two questionnaires Odds Ratio (OR) in finding AHR.ResultsWe have found that ATAQ has a sensitivity and a specificity of 0.72 and 0.45 respectively; instead, ACT has a sensitivity and a specificity of 0.5 and 0.39 respectively in evaluating AHR. Patients with uncontrolled asthma according to ATAQ revealed a significant higher percentage of AHR compared with ACT (72% vs 50%, p < 0.01).Confirming this finding, patients declaring uncontrolled asthma to ATAQ have a significantly higher percentage (34%) of frequent SABAs use than the group with uncontrolled asthma to ACT (21%) (p <0.01).Binomial logistic regression shows how a test revealing uncontrolled asthma is associated with the increasing odds of having AHR according to ATAQ (OR = 3.8, p = 0.05), not to ACT (OR = 0.2, p = 0.1).ConclusionsOur results show that ATAQ reflects AHR and asthma control better than ACT. Children with uncontrolled asthma according to ATAQ have higher odds of having AHR and use of rescue medications (SABAs) compared to patients declaring uncontrolled asthma according to ACT. However both questionnaires are not sufficient alone to fully evaluate asthma control in children and it is always necessary to perform functional tests and investigate patients lifestyle, drug use and other important data that a simple questionnaire is not able to point out
Highlights
Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age
While with Asthma control test (ACT) 85% of patients declared a good and 15% a bad asthma control, with Asthma therapy assessment questionnaire (ATAQ) the well-controlled patients were reduced to 72.5% and the uncontrolled ones increased to 27.5%
We found that patients having uncontrolled asthma to ATAQ had a significantly higher percentage (34%) of frequent short acting beta agonist agents (SABAs) use than the group with uncontrolled asthma according to ACT (21%) (p < 0.01)
Summary
Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. Children had higher rates for asthma primary care and Emergency Department visits, but similar hospitalization rates, and lower death rates [1]. Asthma is one of the major causes of emergency visits per year [2] and is the third leading cause of preventable hospitalization [3]. A divergence between perception of asthma control in patients and asthma control according to guidelines is indubitably present. In a study on several hundred asthmatic patients, despite the fact that 90% of patients were satisfied with their asthma treatment results, just 50% of them had an acceptable asthma control according to guidelines [4]
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