Comparing Asthma Control among Children between 5-18 Years of Age – GINA-2017 based Questionnaire

A recent study aimed to assess asthma control in children in the age-range 5-18 years. The study compared the Asthma Control Test (ACT)/Childhood Asthma Control Test (cACT) Questionnaire, as outlined in the Global Initiative for Asthma 2017 (GINA-2017), against spirometry.

This was a prospective observational study conducted in the pulmonology Outpatient Department (OPD) of a tertiary care center from 2017-2019. Children between 5-18, meeting the inclusion criteria and diagnosed with asthma, underwent spirometry and the cACT/ACT questionnaire before commencing inhaled corticosteroid treatment. After 12 weeks, symptom control was reassessed using both ACT/cACT and spirometry. Qualitative and quantitative data were analyzed.

It was noted that the pretreatment score for ACT/cACT was 12.76 (2.521), which increased to 23.94 (1.941) at follow-up. According to the GINA guidelines, the proportion of patients with control rose from 2.04% to 91.84% at follow-up. Significant improvements were attained in the forced expiratory volume in the first second (FEV1), forced expiratory volume/forced vital capacity (FEV1/FVC), forced expiratory flow between 25 and 75% of FVC (FEF25−75), and peak expiratory flow rate (PEFR) – between pretreatment and follow-up. The percentage changes were − 71.86%, 106.84%, 101.82%, and 97.51%, respectively (versus 82.2%, 109.55%, 110.38%, and 107.00%). Additionally, a positive correlation existed between ACT/cACT and FEV1, as well as PEFR.

The results suggested a strong correlation between symptom control as assessed by ACT/cACT and spirometry, with a notably positive correlation observed for FEV1 and PEFR.

Source: NC G, K N. Indian Journal of Pediatrics. 2023 Aug;90(8):770-5.