Weekly self-measurement of FEV1 and PEF and its impact on ACQ (asthma control questionnaire)-scores: 12-week observational study with 76 patients. (December 2017)

• Record Type: Journal Article
• Authors: Werner, Christoph; Linde, Klaus; Schäffner, Julia; Storr, Constanze; Schneider, Antonius
• Is Part Of: NPJ primary care respiratory medicine. Volume 27(2017)
• Page Start: 1
• Page End: 6
• Publication Date: 2017-12
• Subjects: Respiratory organs -- Diseases -- Periodicals; Primary care (Medicine) -- Periodicals; Respiratory Therapy; Asthma; Primary Health Care; Primary care (Medicine); Respiratory organs -- Diseases; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.2
• DOI: 10.1038/s41533-017-0064-4
• Languages: English
• ISSNs: 2055-1010

Abstract

Abstract The "Asthma Control Questionnaire" (ACQ) is a very common questionnaire for assessing asthma control. This study compares different ACQ versions in a self-monitoring program over a 12-week period combining them with patients' self-measurements of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1). The objective was to test the feasibility of FEV1-self-measurements and to compare ACQ versions regarding possible additional information given by lung function. In this prospective multicenter observational study 100 adult asthma patients, recruited at six family practices and two pulmologists' private practices in Germany, completed the ACQ weekly, performing self-measurements of PEF and FEV1. Seventy-six patients were included into final analysis with only 3% missing values. Scores for all ACQ versions improved significantly (allP -values < 0.05) with reductions of 32% for ACQ5, 31% for ACQ6, 22% for ACQ7-FEV1, and 21% for ACQ7-PEF with high Pearson's correlation coefficients of all scores (r between 0.96 and 0.99). ACQ7-FEV1 scores were significantly higher than others. Separated courses of lung function parameters showed nearly no change, but ACQ5 and ACQ6 as scores for symptoms and reliever medication improved constantly. ACQ5 and ACQ6 revealed higher percentages of patients classified as "controlled" than ACQ7-scores. In conclusion, with only a few missing data points, our results suggest feasibility of FEV1-self-measurements. Courses of symptom-related and lung function-related ACQ items differ clearly. Our results support the GINA recommendations to consider symptoms and lung function separately. FEV1-self-measurements for research purposes may be included with the ACQ, but in clinical practice seem to measure a different domain to symptomatic asthma control. Asthma: self-measurement of lung function is feasible Lung function tests taken by patients at home is doable, but yields different information than self-reports of disease control. Christoph Werner and colleagues from the Technical University of Munich, Germany, tested the feasibility of collecting lung function data from patients who measured forced expiratory volume in one second by themselves. These same patients also completed the Asthma Control Questionnaire (ACQ), which describes symptom severity and medication use. Looking at data from 76 participants, the researchers found that people did well measuring forced expiratory volume in one second, but they could not say whether this test was superior to another metric of lung function that considers peak expiratory flow. The results also showed that symptom scores and lung function assays seem to capture different aspects of the disease, meaning they're worth considering separately rather than lumping together in a single test.