Primary Care Respiratory Journal

Volume 18 Issue 1 March 2009

Original Research

The Asthma Control Test^TM (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey

Pages 41-49
^*Mike Thomas^a, Stephen Kay^b, James Pike^b, Angela Williams^c, Jacqueline R Carranza Rosenzweig^c, Elizabeth V Hillyer^d, David Price^a

^aCentre of Academic Primary Care, University of Aberdeen, Scotland, UK

^bAdelphi Real World Products, Bollington, UK

^cGlobal Health Outcomes, GlaxoSmithKline R&D, Research Triangle Park, North Carolina, USA

^dRespiratory Research Ltd, Norwich, UK

Received 28 May 2008 • Accepted 28 November 2008 • Online 24 February 2009

Abstract
AIMS: To evaluate whether the Asthma Control TestTM (ACT) score is predictive of Global Initiative for Asthma (GINA) guideline-defined classification levels of asthma control. The ACT is a validated, 5-item, patient-completed measure of asthma control with a recall period of four weeks. METHODS: Cross-sectional survey comparing ACT score and GINA classification of asthma control among 2949 patients attending primary care physicians and specialists in France, Germany, Italy, Spain, the UK, and the USA. RESULTS: The area under the receiver operating characteristics curve for ACT score predicting GINA control was 0.84 (95% CI 0.82–0.85). An ACT score of <19 (not well-controlled asthma) correctly predicted GINA-defined partly controlled/uncontrolled asthma 94% of the time, while an ACT score of >20 predicted GINA-defined controlled asthma 51% of the time, with kappa statistic of 0.42, representing moderate agreement. CONCLUSIONS: An ACT score <19 is useful for identifying patients with poorly controlled asthma as defined by GINA.

Cite as: Thomas M, Kay S, Pike J, Williams A, Rosenzweig JRC, Hillyer EV, Price D. The Asthma Control Test^TM (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey. Prim Care Respir J 2009;18(1):41-49. DOI: http://dx.doi.org/10.4104/pcrj.2009.00010

Keywords
Asthma, Asthma Control Test, control, GINA, exacerbations, multinational survey, patient-completed outcome assessment, Europe, United States

* Corresponding author. Mike Thomas Tel: +44 (0)23 80 241050 Fax: +44 (0)23 80 241050 Email: D.M.Thomas@soton.ac.uk

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