We hypothesized that the asthma control test (ACT) and %predicted peak expiratory flow rate (PEFR) are independent clinical management tools. We also studied whether the presence of nasal symptoms regardless of etiology is correlated to these measures.
Serial visits at separate 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 (PEF) and had more than one provider visit. Patients with other major diseases were excluded. We determined whether uncontrolled asthmatics, defined as an 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 mean ACT and airway function for the group was determined. Patients with nasal symptoms at the time of presentation were sub-analyzed to determine whether their ACT and %predicted PEFR measurements were significantly lower.
Based on n = 45 physician visits, the mean ACT score was 21 +/− 3.3 (range 12–25) and the mean % predicted PEFR was 87.4%O +/− 11 (range 65–109%). Patients with ACT scores less than or equal to 19, or peak expiratory flow rates less than 90% predicted were determined to not have more frequent nasal symptoms. The measures of ACT and peak expiratory flow were independent and not correlated (p = ns).
The use of observed PEFR measurements and of the ACT symptom score are independent tools in the management childhood asthma. The presence of nasal symptoms does not correspond to lower PEFR or ACT scores.
Our study indicates that ACT and PEFR are distinct parameters of asthma management in a pediatric outreach asthma clinic.
Marilynn Chan, Grant monies (from industry related sources) Dr. Dosanjh is on the speakers bureau of Mediimmune.; No Product/Research Disclosure Information