PURPOSE: Increasing prevalence of asthma is a cause of unmet demands on our health services and an economic burden. The introduction of ACT by Nathan et al. (2004), a simple clinical method to evaluate control of asthma, prompted us to study its use in comparison with spirometry in an asthma clinic.
METHODS: The ACT was applied to patients 12 years of age or older attending an asthma clinic. In the waiting room, a physician explained each of the five questions of ACT and then each group of up to ten patients filled up the survey. A total of 25 points indicates complete control, from 20 to 24 points good control and less than 20 points out of control. Afterwards, a spirometric test was done in every patient.
RESULTS: A total of 51 subjects, 72,5% of them female, with mean age of 47 years ±21.4 standard deviation (SD) took part in the study. The ACT survey showed an average of 16.1±5.0 of total points. The mean result and SD of the pulmonary function tests as percent of predicted values were: FEV1 74.5%±22.1, FVC 85.3%±16.7, PEF 75.8%±27.9, FEF25-75 37.4%±26.2. 51% of the patients had a FEV1 of less than 80% of predicted but 72,5% of the subjects had less than 20 points (asthma out of control). All the 12 patients with FEV1 less than 60% had asthma out of control. However, from the 37 patients with asthma out of control, 43.2% had a FEV1380% of predicted.
CONCLUSION: Our data show that a large proportion of patients with FEV1 equal or higher than 80% predicted may be out of control according to ACT survey.
CLINICAL IMPLICATIONS: The use of FEV1 or peak expiratory flow may be misleading as an indicator of asthma control.
DISCLOSURE: Laercio Valenca, None.