RESUMEN
Asthma control and quality of life are expected to be correlated. We aimed to evaluate the association of asthma control test (ACT) with asthma quality of life questionnaire (AQLQ) and guideline based control assessment. We also aimed to investigate the impact of therapy adjustment according to ACT score on AQLQ A total of 101 asthmatic patients were included. ACT, AQLQ and Global Initiative for Asthma (GINA) based control assessments were performed. Based on ACT, treatment was adjusted by stepping down in controlled and stepping up in uncontrolled/partly controlled patients. In some controlled/partly controlled patients, no therapy adjustment was done. After 3-months the same parameters were reevaluated.We found a statistically significant association between ACT and AQLQ, a one point increase in ACT was associated with a 0.129 point increase in AQLQ. ACT scores increased significantly in the step-up group; however AQLQ total scores were not affected after therapy adjustment. We found that ACT was concordant with GINA recommended control classification in the first (kappa=0.511, 7.718) and third months (kappa=0.599, 7.912) (P<0.001 for both).We determined an association between ACT and AQLQ. ACT was also found fairly concordant with GINA. However, treatment adjustment according to ACT was not found satisfactory in terms of quality of life.
Asunto(s)
Asma/diagnóstico , Calidad de Vida , Encuestas y Cuestionarios , Adulto , Factores de Edad , Asma/fisiopatología , Asma/psicología , Asma/terapia , Femenino , Adhesión a Directriz , Humanos , Modelos Lineales , Pulmón/efectos de los fármacos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del TratamientoRESUMEN
We aimed to investigate the validity and reliability and of "Asthma Quality of Life Questionnaire (AQLQ)" in Turkish adult asthmatic patients. New or previously diagnosed [according to Global Initiative for Asthma (GINA) 2008] symptomatic 118 consecutive stable asthmatic patients between 18 and 55 years old were included. Asthma severity was determined and Turkish adaptation of the AQLQ was administered. Lara asthma symptom scales (LASS), pulmonary function tests, Turkish adaptation of Medical Outcomes Survey Short Form-36 (SF-36) were evaluated. All assessments were done twice at recruitment and after 10 weeks. During this period patients were allowed to make modifications on their medication when necessary. Among the recruited 118 patients 95 were female and 14 were lost in the follow-up. Sixty-two percentages of the patients had mild and 38% moderate asthma. The internal consistency of AQLQ was high (Cronbach's alpha 0.81-0.87) and item-total score correlations were ranging from 0.75-0.89. The cross-sectional and longitudinal correlations between AQLQ total and domain scores and SF36 domain scores were in a range of little or fair degree (r= 0.241-0.626, p< 0.005). Total AQLQ scores were observed significantly different according to disease severity and LASS both in the first (p< 0.001, both) and 10 weeks follow-up visits (p= 0.006, p< 0.001 respectively). A statistical significant change was observed in AQLQ symptom score as in total LASS changed (p< 0.001, both) in the follow-up. Our results demonstrated that Turkish version of AQLQ is feasible, reliable, valid and sensitive to changes in adult asthmatics.
Asunto(s)
Asma/psicología , Calidad de Vida , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Pruebas de Función Respiratoria , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Traducción , Turquía , Adulto JovenRESUMEN
BACKGROUND AND AIMS: The treatment of asthmatic patients is particularly focused on the control of symptoms as well as functional and inflammatory parameters. In our study, we investigated the relationship between the asthma control test (ACT) which evaluates symptoms and airway inflammation and functional parameters. MATERIALS AND METHODS: Stable asthmatic patients admitted to our pulmonary outpatient clinic were enrolled in the study consecutively and underwent the ACT, pulmonary function tests and methacholine bronchial provocation test (MBPT). Additionally, fractional exhaled nitric oxide level (FeNO) and induced sputum cell distribution were assessed. All these parameters were re-evaluated at the third month after adjusting medications of the patients according to baseline ACT scores. RESULTS: Of the 101 patients screened, we analyzed 83 who proceeded to the follow up visit. At the baseline visit, 8 were totally controlled, 36 partially controlled and 39 uncontrolled according to ACT. At the follow up visit, 10 were totally controlled, 39 partially controlled and 34 uncontrolled. Comparison of the two visits in terms of all parameters revealed significant reductions only in the percentages of patients with MBPT positivity (p = 0.029) and FeNO levels > 20 ppb (p = 0.025) at follow up. The percentages of patients with FeNO > 20 ppb, MBPT positivity, induced sputum eosinophilia or induced sputum neutrophilia did not show significant differences between totally controlled, partially controlled and uncontrolled groups at both baseline and follow up visits. CONCLUSION: Although the ACT scores did not show significant correlations with the airway inflammation parameters tested in this study, a marked reduction in the percentage of patients with MBPT positivity and FeNO > 20 ppb at follow up may suggest the importance of the control concept in the management of asthma.