New tool helps monitor asthma symptoms

The new Asthma Symptom Tracker (AST), which rests on weekly (instead of traditional monthly) use of the Asthma Control Test (ACT), facilitates monitoring of patients’ symptoms and rapid recognition and response to warning signs of deterioration in asthma control, a new study found. The investigation looked at 210 children aged from 2 to 18 years who were hospitalized for asthma, then followed for more than 6 months after discharge, while using the AST tool.

The AST includes user instructions on answering the ACT questionnaire and calculating and plotting the child’s score on a graphic display, which also provides color-coded zones indicating the asthmatic’s level of symptom control, using the standard ACT cutoff points. A “decision support” section includes 3 color-coded boxes that show when asthma control scores fall within the green zone (well controlled), or yellow or red zones (not well controlled), which are expected to prompt a follow-up physician visit. 

For comparison purposes, investigators also administered the Asthma Control Questionnaire (ACQ). The ACT and ACQ both assess levels of asthma control, but higher scores on the ACT (and hence the AST) indicate better symptom control, whereas higher scores on the ACQ indicate the reverse-more severe symptoms.

A decrease in AST scores (meaning less symptom control) was associated with an increase in use of oral steroids and unscheduled acute care visits (Nkoy FL, et al. Pediatrics. 2013;132[6]:e1554-e1561).   

COMMENTARY  The point of this study is to allow patients and families to systematically monitor asthma symptom severity and then to intervene before deterioration leads to a full-blown asthma attack. In the words of the researchers, “Most asthma exacerbations are preventable because they rarely occur without warning.” In a family that is organized and energized enough to use this tool on a weekly basis, this may prove to be a practical approach to effectively managing asthma. -Michael Burke, MD

MS FREEDMAN is a freelance medical editor and writer in New Jersey. DR BURKE, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland, and physician contributing editor for Contemporary Pediatrics. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.