Asthma control test: Cut off values of control according to GINA guideline and its ability to predict exacerbations and treatment decisions

Introduction: This study assessed ACT cut-off values for asthma control according to the GINA guideline in adults. ACT score in the prediction of exacerbations and serial changes in ACT score over time in relation to treatment decisions was also assessed. Methods: Subjects completed ACT together with same-day spirometry and fractional concentration of exhaled nitric oxide (FeNO) measurement at baseline and at 3 months. Physicians, blinded to the ACT scores and FeNO values, assessed the patient9s asthma control in the past month and adjusted the asthma medications according to management guideline. Asthma exacerbations and urgent health care utilization (HCU) at 6 months were recorded. Results: 379 (120 men) asthmatics completed the study. The ACT cut-off for uncontrolled and partly controlled asthma were ≤19 (sensitivity 0.73, specificity 0.67,% correctly classified 69.5) and ≤22 respectively (sensitivity 0.73, specificity 0.71,% correctly classified 72.1). Baseline ACT score had an odds ratio of 2.34 (95%CI 1.48-3.69) and 2.66 (1.70-4.18) for urgent HCU and exacerbations respectively at 6 months (p Conclusion: Single measurement of ACT is a useful tool for assessment of asthma control, prediction of exacerbation and changes in treatment decisions.