Difference in asthma control levels by assessment tools: Observational study

Background: Asthma control levels are evaluated based on patient self-questionnaires such as Asthma Control Questionnaire (ACQ) and Asthma Control Test (ACT), and/or using guidelines such as Global Initiative for Asthma (GINA), National Asthma Education and Prevention Program (NAEPP), and asthma prevention and management guideline (JGL) by physicians. Possible difference has been reported in the asthma control levels based on patient questionnaires and guidelines. Japan Asthma Control Survey (JACS) questionnaire was developed to evaluate asthma control levels in Japanese patients. Aims and Objectives: To investigate the difference in asthma control levels based on patient self-report and physician’s evaluation using guidelines. Methods: Baseline data of 420 asthma patients (55.1 ± 13.5 years old, 62% female) enrolled in a 24-week observational study and treated with ICS/LABA were evaluated in this cross-sectional analysis. Distribution of the asthma control levels between physician’s assessment based on JGL and patient self-report using JACS or ACQ6 at week 0 were compared. Results: Mean baseline ACQ6 score and JACS total score were 0.59±0.70 and 7.8±1.3, respectively. Distribution of the control levels based on JGL (well-controlled 64.8%, not well-controlled 30.2%, and poorly controlled 5.0%) was similar to that of JACS (p=0.185), whereas a significant difference between the distributions of ACQ6 and JGL was observed (p<0.001). Conclusions: Difference existed in asthma control levels between ACQ6 and JGL, while no difference was observed between JACS and JGL. Newly developed JACS questionnaire was considered reliable to evaluate asthma control levels, and may contribute to accurate asthma control assessment.