The role of education in the self-compilation of asthma control test score in patients with asthma.

Background: Asthma Control Test (ACT) is a quick and easy tool that allows physicians to estimate the control of asthma symptoms. Previous studies showed that ACT can be self or physician-administered with similar results.

Aim: The aim of our study was to evaluate the role of instruction in the self-compilation of ACT and its difference with the physician-administered modality.

Methods: We enrolled 114 patients with asthma from those attending our outpatient clinic. We divided our population into 3 groups, according to their level of education: 1) low level (primary, middle school; n= 34, age 54.3±11.1), 2) middle level (secondary school; n=44, age 38.2±13.8) and 3) high level (university degree; n=34, age 44.8±14.7). All participants answered the questionnaire in both self- and physician-administered ways. Then, we calculated the parameter ΔACT, defined as the difference between physician-administered and self-administered ACT score. The comparison of ΔACT among groups was assessed by Mann-Whitney U test. Moreover, Spearman correlation was used to assess linear relationship between physician- and self-administered ACT in the three groups.

Results: Patients with low and middle education level had higher median ΔACT compared to individuals with high education level (2.17 and 2.15 vs 0.75, p<0.05 for both analysis). Moreover, the R2 value of the high education group (0.915) was higher than those with middle and low education (0.642 and 0.773, respectively).

Conclusions: Our data suggest that patients without high education levels tend to overestimate their perception of asthma symptoms. Thus, ACT should always be physician-administered in these asthmatic patients.