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Asthma control test and peak expiratory flow rate: independent pediatric asthma management tools
M Chan1, S Sitaraman, A Dosanjh
1Department of Pediatrics, University of California School of Medicine, La Jolla, California, USA.
Insights
The Asthma Control Test (ACT) and peak expiratory flow rate (PEFR) are independent tools for managing pediatric asthma. Nasal symptoms did not correlate with asthma control or airway function in this study.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Asthma Management
Background:
- Asthma management complexity necessitates validated assessment tools.
- National Heart Lung Blood Institute guidelines recommend the Asthma Control Test (ACT), airway function, and quality of life assessments.
- The independence of ACT and airway function measures in asthma management requires further investigation.
Purpose of the Study:
- To determine if the Asthma Control Test (ACT) and peak expiratory flow rate (PEFR) are independent tools in pediatric asthma management.
- To investigate the correlation between nasal symptoms and asthma control or airway function.
- To analyze ACT and airway function results in a pediatric outreach clinic setting.
Main Methods:
- Retrospective review of 45 patient visits at a pediatric respiratory clinic in an underserved area.
- Inclusion criteria: ability to perform airway function tests and multiple provider visits.
- Analysis of ACT scores (≤19 defined uncontrolled asthma) and % predicted PEFR, with sub-analysis for nasal symptoms.
Main Results:
- Mean ACT score was 21 (±3.3), and mean PEFR was 87.4% (±11).
- No significant correlation was found between ACT scores and PEFR measurements.
- Nasal symptoms were not found to be more prevalent in patients with uncontrolled asthma or lower PEFR.
Conclusions:
- The Asthma Control Test (ACT) and peak expiratory flow rate (PEFR) serve as distinct and independent parameters for managing pediatric asthma patients.
- These findings support the use of both ACT and PEFR as separate tools in clinical practice.
- Nasal symptom presence does not appear to influence asthma control or airway function measures in this population.
Background:
Management of asthma reflects the complexity of the pathogenesis. According to current National Heart Lung Blood Institute (NHLBI) guidelines, asthma control can be assessed using the validated asthma control test, measures of airway function, and overall assessment of risk and quality of life. We hypothesized that the asthma control test and measures of airway function are independent tools in asthma management. We also studied whether the presence of nasal symptoms is correlated to these measures.
Methods:
Serial visits (n = 45) to a pediatric respiratory clinic in an underserved area of San Diego County with a predominantly Hispanic population were reviewed. Patients were included if they were able to perform airway function tests and had more than one provider visit. Patients with other major diseases were excluded. We determined whether uncontrolled asthmatics, defined as an Asthma Control test (ACT) score of 19 or less, had lower % predicted peak expiratory flow Measurements as a group compared to those with higher scores. In addition, the individual ACT and airway function results were analyzed. Patients with and without nasal symptoms at the time of presentation were sub-analyzed to determine differences in ACT and peak flow measurements.
Results:
Based on n = 45 physician visits, the mean ACT score was 21 +/- 3.3 (range 12-25) and the mean peak expiratory flow rate (PEFR) was 87.4% +/- 11 (range 65-109%). Patients with ACT scores < or = to 19 or lower (< or = 90%) PEFRs were determined not to have more nasal symptoms. The measures of ACT and peak expiratory flow were independent and not correlated.
Conclusions:
Our study indicates that ACT and PEFR are distinct parameters used to manage patients in a pediatric outreach asthma clinic.
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