Adequate assessment of control is critical to asthma management. The Asthma Control Questionnaire (ACQ) and the National Asthma Education and Prevention Program (NAEPP) criteria are commonly used measures of asthma control.
This study is to examine the relationships between the ACQ and NEAPP criteria and compare the validity in association with lung function, asthma exacerbation and quality of life.
The ACQ and the NAEPP criteria were administered to 373 adolescents with asthma, aged 12-20. The two measures correlated with FEV1, asthma exacerbation (oral corticosteroid [OCS] use, hospitalization and emergency department [ED] use) in the past 12 months, and quality of life.
Agreement between the ACQ and NEAPP criteria was moderate (Kappa=0.40 to 0.61). Neither of the two measures was a reliable predictor of FEV1<80% due to high false positives for ACQ (68%) and low sensitivity for NAEPP (49%). The NAEPP identified more cases of uncontrolled asthma (84.6%) than ACQ (64.6%). The ACQ was a significant predictor of recent OSC use, hospitalization, and ED visits (AUC=0.66, 0.66, 0.64, respectively; p<0.001), as was NAEPP (AUC=0.63, 0.66, 0.61, respectively; p<0.001). Both measures significantly associated with quality of life, and the relationships were particularly strong for ACQ (r=-0.87 for symptom subscale; r=-0.76 for activity subscale; and r=-0.78 for emotional function subscale).
Neither ACQ nor NAEPP appears to reliably predict lung function, while both measures reasonably associate with acute asthma exacerbation. The ACQ may be the superior measure in gauging the psychosocial impact of asthma control given its particularly strong associations with quality of life.
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