Avaliação do controlo da asma: Utilização de diferentes métodos

Translated title of the contribution: Asthma control evaluation: Application of different methods

Miguel Paiva, Pedro Martins, Susana Carvalho, Marta Chambel, Anália Matos, Isabel Almeida, Ana Luísa Papoila, Nuno Neuparth, Paula Leiria Pinto

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Asthma is a chronic respiratory disease and its control should be adequately monitored. The Asthma Control Test (ACT) is a validated questionnaire for asthma control evaluation. Several guidelines suggest that clinical evaluation should be complemented by lung function studies. Aim: To determinate risk factors for uncontrolled asthma and evaluate the association between ACT and the results of respiratory tests (RT). Methods: Over a period of two weeks, the ACT questionnaire was completed by all patients aged 12 years or older (n = 103) that went to the Lung Function Laboratory at Hospital de Dona Estefânia. They underwent RTs that included a plethysmography with bronchodilation and FENO measurements. Uncontrolled asthma was defined as an ACT < 20. The defined criteria for RTs were: FEV1/VC ratio < 0.75; FEV1< 80%, RV > 140%, FEF25-75% < 60% of predicted value; ΔFEV1 12% and higher than 200ml in relation to the basal value, and FENO > 35ppb. Results: We studied 51 males and 52 females, with a median age of 18 years (Q1-Q3:15-36 years). Eighty per cent were sensitized to aeroallergens. There was no association between ACT and RTs. In the multivariate analysis, females had a higher risk for ACT < 20 (OR:3.83; CI 95%:1.36-10.80; p = 0.011) and a FEF 25-75% < 60% (OR:3.92, CI 95%:1.07-14.33; p = 0.039). Being 18 years or older was a risk factor for FEV1VC < 0.75 (OR:5.63 CI 95%:1.85-17.18; p = 0.002) and low FEF 25-75% < 60% (OR:20.40; CI 95%:2.52-164.77; p = 0.005). The female gender and age > 18 years were associated with a decreased risk of FENO > 35ppb. Conclusions: Female gender constituted a risk factor for uncontrolled asthma. Patients aged 18 years or older had increased risk of functional respiratory changes. The discordance between ACT and RTs could result from the fact that different methods evaluate different aspects of the disease (clinical, inflammatory, respiratory function). We suggest that clinical evaluation should be complemented by lung function evaluation.

Original languagePortuguese
Pages (from-to)227-241
Number of pages15
JournalRevista Portuguesa de Imunoalergologia
Volume18
Issue number3
Publication statusPublished - 1 May 2010

Keywords

  • ACT
  • Asthma
  • Control
  • FNO

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