TY - JOUR
T1 - Comparing the Asthma APGAR system and the Asthma Control Test™ in a multicenter primary care sample
AU - Rank, Matthew A.
AU - Bertram, Susan
AU - Wollan, Peter
AU - Yawn, Roy A.
AU - Yawn, Barbara P.
N1 - Funding Information:
This is a substudy of a trial funded by the Agency for HealthCare Quality and Research. The parent “Asthma Tools Study” is a randomized controlled pragmatic trial to test the effectiveness of the Asthma APGAR system 2 in primary care practices. The protocol has been presented in detail previously. 20 In brief, 20 primary care practices (members of 2 practice-based research networks) were randomized to either intervention or usual care. Randomization was stratified by whether the practice is part of a family medicine residency program and whether it is a family medicine or general pediatrics practice.
PY - 2014/7
Y1 - 2014/7
N2 - Objective: To compare asthma control assessment using the Asthma APGAR system, a tool developed byprimary care clinicians, in a multicenter primary care sample with the Asthma Control Test (ACT™)/Childhood Asthma Control Test (CACT™), a tool developed by asthma specialists. Patients and Methods: This is a substudy of a multicenter, randomized, controlled pragmatic trial that tests the effectiveness of the Asthma APGAR system in primary care practices. As part of the study, enrolled patients completed both the ACT™/CACT™ and the Asthma APGAR system between March 1, 2011, and December 31, 2011. Kappa and McNemar statistics were used to compare the results of questionnaires. Results: Of the 468 patients in our sample, 306 (65%) were classified as not controlled by the ACT™/CACT™ or the Asthma APGAR system. The overall agreement was 84.4%, with a kappa value of .68 (substantial agreement) and a McNemar test P value of .35 (suggesting no significant difference in the direction of disagreement). Of those with poor control as defined by the Asthma APGAR system, 23.8% (73) had no controller medications and 76.5% (234) were seldom or sometimes able to avoid identified triggers for their asthma. Of those who stated that they had been prescribed controller medications, 116 of 332 (35%) stated that they did not use the controller medication on a daily basis. Conclusion: The Asthma APGAR system and the ACT-/CACT- similarly assess asthma control in a multicenter primary careebased sample. The Asthma APGAR system identified an "actionable item" in more than 75% (234) of the individuals with poor asthma control, thus linking an assessment of poor asthma control with a management strategy.
AB - Objective: To compare asthma control assessment using the Asthma APGAR system, a tool developed byprimary care clinicians, in a multicenter primary care sample with the Asthma Control Test (ACT™)/Childhood Asthma Control Test (CACT™), a tool developed by asthma specialists. Patients and Methods: This is a substudy of a multicenter, randomized, controlled pragmatic trial that tests the effectiveness of the Asthma APGAR system in primary care practices. As part of the study, enrolled patients completed both the ACT™/CACT™ and the Asthma APGAR system between March 1, 2011, and December 31, 2011. Kappa and McNemar statistics were used to compare the results of questionnaires. Results: Of the 468 patients in our sample, 306 (65%) were classified as not controlled by the ACT™/CACT™ or the Asthma APGAR system. The overall agreement was 84.4%, with a kappa value of .68 (substantial agreement) and a McNemar test P value of .35 (suggesting no significant difference in the direction of disagreement). Of those with poor control as defined by the Asthma APGAR system, 23.8% (73) had no controller medications and 76.5% (234) were seldom or sometimes able to avoid identified triggers for their asthma. Of those who stated that they had been prescribed controller medications, 116 of 332 (35%) stated that they did not use the controller medication on a daily basis. Conclusion: The Asthma APGAR system and the ACT-/CACT- similarly assess asthma control in a multicenter primary careebased sample. The Asthma APGAR system identified an "actionable item" in more than 75% (234) of the individuals with poor asthma control, thus linking an assessment of poor asthma control with a management strategy.
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U2 - 10.1016/j.mayocp.2014.02.016
DO - 10.1016/j.mayocp.2014.02.016
M3 - Article
C2 - 24809759
AN - SCOPUS:84904740601
SN - 0025-6196
VL - 89
SP - 917
EP - 925
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 7
ER -