Rutgers Institute for Translational Medicine and Science, The State University of New Jersey, New Brunswick, NJ, USA.
Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA.
J Asthma. 2022 Sep;59(9):1859-1868. doi: 10.1080/02770903.2021.1963766. Epub 2021 Nov 5.
For patients with severe asthma (SA), overestimation of asthma control may lead to poorer outcomes. The objective of this study was to assess concurrent patient and specialist assessments of asthma control and treatment effectiveness among a large US cohort of SA patients.
CHRONICLE is an ongoing observational study of patients with SA treated by US subspecialists. Asthma control was assessed using the patient-completed Asthma Control Test™ (ACT™) and specialist clinical assessment of control. Treatment effectiveness was measured using the Global Evaluation of Treatment Effectiveness (GETE) completed by patients and specialists.
1109 patients who completed online surveys at enrollment were included. 14%, 28%, 25%, and 33% of patients had ACT™ scores of 5-9, 10-15, 16-19, and 20-25, respectively. Compared with 67% of patients with uncontrolled asthma by ACT™, 44% were uncontrolled by specialist assessment. 54% of patients who were uncontrolled according to the ACT™ were rated as controlled by specialists, demonstrating overestimation of asthma control. Based on ACT™ score, asthma control was more frequent among patients treated with biologics compared to other treatments. Using the GETE, 90% of patients reported treatment effectiveness compared with 71% of specialists. Patient and specialist treatment effectiveness categorizations agreed 73% of the time.
Specialists commonly overestimated asthma control relative to ACT™ scores. Patients reported treatment effectiveness more frequently than specialists. These findings emphasize the importance of validated instruments to assess asthma control and reduce potential treatment gaps associated with patient-specialist discordance.
ClinicalTrials.gov Identifier: NCT03373045.
对于重度哮喘（SA）患者，对哮喘控制的高估可能导致预后较差。本研究的目的是评估美国大型 SA 患者队列中，患者和专家对哮喘控制和治疗效果的同时评估。
CHRONICLE 是一项正在进行的美国专家治疗的 SA 患者观察性研究。使用患者完成的哮喘控制测试（ACT）™和专家对控制情况的临床评估来评估哮喘控制。使用患者和专家完成的全球治疗效果评估（GETE）来衡量治疗效果。
共纳入 1109 名在入组时完成在线调查的患者。分别有 14%、28%、25%和 33%的患者 ACT™评分分别为 5-9、10-15、16-19 和 20-25。与 ACT™评估的未控制哮喘患者中 67%相比，有 44%的患者被专家评估为未控制。根据 ACT™评估，有 54%的未控制哮喘患者被专家评为控制，表明对哮喘控制的高估。根据 ACT™评分，与其他治疗相比，生物制剂治疗的患者哮喘控制更为常见。根据 GETE，90%的患者报告了治疗效果，而专家的比例为 71%。患者和专家的治疗效果分类有 73%的时间是一致的。
专家通常相对于 ACT™评分高估了哮喘控制。患者比专家更频繁地报告治疗效果。这些发现强调了使用经过验证的工具评估哮喘控制的重要性，以减少与患者与专家意见不一致相关的潜在治疗差距。
ClinicalTrials.gov 标识符：NCT03373045。
