Asthma Control Test

The test for the control of asthma in children is a reliable tool for assessing the effectiveness of treatment for bronchial asthma.

Due to the fact that the main goal of treating asthma patients is to achieve and maintain a long-term control over the disease, therapy should begin with an assessment of the current control of asthma, and the volume of treatment should be regularly reviewed in order to provide control.

The complexity and laboriousness of assessing asthma control as an integral indicator in real practice conditions necessitates the introduction and use of adequate and effective tools. In the process of developing methods of aggregate control, several assessment tools have emerged, including the questionnaire - ACQ (Asthma Control Questionnaire). RCP (Royal College of Physicians), Rules of Two, and others for older children. One of the simplest methods that showed a high reliability of asthma control assessment in real clinical practice is the Asthma Control Test questionnaire . Its use was recommended by GINA, 2006. Before the beginning of 2007, the "Asthma Control Test" was available only for adults and children over 12 years of age, but in 2006 its child version was proposed, which today is the only tool for assessing control asthma in children aged 4-11 years.

The Childhood Asthma Control Test consists of seven questions, with questions 1-4 for the child (a 4-point grading scale: 0 to 3 points), and questions 5-7 for parents (6 scale: from 0 to 5 points). The result of the test is the sum of the scores for all the answers in points (the maximum score is 27 points), on the value of which recommendations for further treatment of patients will depend. Assessment for the Asthma Control Test in children 20 points or higher corresponds to a controlled asthma, 19 points or lower means that asthma is not adequately controlled; The patient is recommended to take the help of a doctor to review the treatment plan. In this case, it is also necessary to ask the child and his parents about medications for daily use to make sure that the inhalation technique is correct and that the treatment regimen is adhered to.

Objectives of using the Asthma Control Test:

• screening patients and identifying patients with uncontrolled asthma;
• making changes to the treatment to achieve better control;
• increase the effectiveness of implementation of clinical recommendations;
• identification of risk factors for uncontrolled asthma;
• monitoring of the degree of asthma control by both clinicians and patients in any setting.

Conceptually, the questionnaire corresponds to the set of goals for the treatment of asthma in the updated GINA manual (2006), since it is aimed at achieving the maximum result for each patient with asthma. It allows you to evaluate various aspects of the patient's condition and treatment, is convenient for use in outpatient or inpatient settings and is sensitive to changes in the patient's condition. The questionnaire is easy to use for medical personnel and patients. Finally, the result is easy to interpret, it is the most objective and allows you to evaluate the control of asthma in dynamics. This test is recommended for use by the main international guidelines for the diagnosis and treatment of bronchial asthma - GINA (2006).

In the national program "Bronchial asthma in children. The strategy of treatment and prevention "attach great importance to regular dispensary supervision and training of parents and children in self-monitoring methods. To this end, using a peakflow system with a system of color zones (similar to a traffic light signal).

Green zone: the child's condition is stable, the symptoms are absent or minimal. The peak volumetric expiratory flow rate is more than 80% of the norm. Child Can lead a normal lifestyle, do not take medicines, or continue unchanged the therapy prescribed by the doctor.

Yellow zone: mild symptoms of asthma appear - episodes of coughing and wheezing, disturbance of well-being, peak volumetric Exhalation rate less than 80% of the age norm.

In this case, it is necessary to increase the amount of treatment, in addition to take the medicines recommended by the doctor. If the condition does not improve within 24 hours, consult a doctor.

Red zone: state of health is bad, there are bouts of coughing, choking, including night attacks. The peak space velocity is less than 50%. All this is an indication for an urgent medical consultation. If the patient previously took hormonal medications, you should immediately give the patient prednisolone inside at the recommended dose and immediately hospitalize the patient.

First aid at an outpatient stage for mild and moderate bronchial asthma in cases of exacerbation: inhalations of short-acting beta-agonists (1 inhalation every 15-30 seconds - up to 10 inhalations) through the nebulizer are used. If necessary, inhalation is repeated at intervals of 20 minutes 3 times for an hour.

With exacerbation of bronchial asthma of severe course, bronchospasmolytic agents are appointed through the nebulizer, enhances the effect of beta-agonists by the appointment of ipratropium bromide through a nebulizer at 0.25 mg every 6 hours. In patients with severe bronchial asthma, previously treated with corticosteroids or on IGCC therapy, systemic corticosteroids are given a short course in tablets or IV every 6 hours. A good effect for relieving exacerbation is inhalation through the nebulizer budesonide (pulmicort) at a dose of 0.5-1 mg / day.

First aid in case of acute attack: ensure access to fresh air; to give the child a comfortable position; to determine the cause of the attack and, if possible, to eliminate it; give a warm drink; to inhale the bronchodilator using a nebulizer; with persistent difficulty breathing repeat the procedure after 20 minutes; in the absence of the effect of bronchodilator inhalation, enter in / in the euphyllin, glucocorticosteroids. If the above measures are ineffective within 1-2 hours, hospitalization of the patient is necessary.

[1], [2], [3]