Pinto Pereira L M, Boodoo S, Dindial K A, Hosein A, Seemungal T A R, Bekele I
Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago, West Indies.
West Indian Med J. 2009 Jun;58(3):214-8.
Asthma control has not been formally evaluated in the Caribbean. This study evaluated disease control on The Asthma Control Test (ACT), The Royal College of Physicians "Three questions" for Assessing Asthma Control (RCP), peak expiratory flow rate (PEFR) and patients' self-assessment of control.
Asthma control was examined in a cross-section of 205 asthmatics above 16 years of age using the ACT, RCP and on the PEFR % predicted. Scores below 20 and equal to or above 1 on the ACT and RCP respectively, and PEFR below 80% predicted indicated uncontrolled asthma. Patients stated whether they perceived their asthma was controlled or uncontrolled.
Overall there were more females (63.9%, p < 0.001) than males (36.1%). Males aged between 17-30 years predominated (60.8%, p < 0.001) with gender reversal beyond 30 years of age (33.2%, p < 0.002) years. Self-assessed control was higher (69.3%, p < 0.001) than control evaluated by the ACT and RCP tests, which were comparable (p > 0.05). Fewer patients (13.2%) achieved control on PEFR > 80% predicted than on the ACT (22.4%) and RCP (18%). The Kappa statistic indicated good reproducibility of the RCP and ACT and concordance between the PEFR and RCP (0.63) and the PEFR and ACT (0.56). Higher education was associated with control on the ACT (p < 0.0005) and RCP (p < 0.002) but not on PEFR or self-assessment (p > 0.05).
Approximately 80% of study asthmatics were uncontrolled, and patients tended to overestimate their disease control. The ACT and RCP instruments were comparable with the PEFR. Efforts to study their validity and formal evaluation of asthma control in Trinidad are recommended.
哮喘控制情况在加勒比地区尚未得到正式评估。本研究使用哮喘控制测试（ACT）、英国皇家内科医师学会评估哮喘控制的“三个问题”（RCP）、呼气峰值流速（PEFR）以及患者的自我控制评估，对疾病控制情况进行了评估。
对205名16岁以上的哮喘患者进行横断面研究，使用ACT、RCP以及预计PEFR百分比来检查哮喘控制情况。ACT得分低于20分，RCP得分等于或高于1分，以及PEFR低于预计值的80%均表明哮喘未得到控制。患者需说明他们认为自己的哮喘是得到控制还是未得到控制。
总体而言，女性患者（63.9%，p < 0.001）多于男性患者（36.1%）。年龄在17至30岁之间的男性占主导（60.8%，p < 0.001），30岁以上性别比例反转（33.2%，p < 0.002）。自我评估的控制情况高于通过ACT和RCP测试评估的控制情况（69.3%，p < 0.001），而ACT和RCP测试结果具有可比性（p > 0.05）。与ACT（22.4%）和RCP（18%）相比，达到PEFR > 80%预计值控制标准的患者较少（13.2%）。Kappa统计量表明RCP和ACT具有良好的可重复性，且PEFR与RCP（0.63）以及PEFR与ACT（0.56）之间具有一致性。高等教育与ACT（p < 0.0005）和RCP（p < 0.002）的控制情况相关，但与PEFR或自我评估无关（p > 0.05）。
约80%的研究对象哮喘未得到控制，且患者往往高估其疾病控制情况。ACT和RCP工具与PEFR具有可比性。建议在特立尼达研究它们的有效性并对哮喘控制情况进行正式评估。
