Short-acting β-agonist use as a marker of current asthma control
Background The relationship between current asthma symptoms and rescue bronchodilator (reliever) use is uncertain, leading to different recommendations about the preferred reliever metric to use when assessing asthma control. In a 6-month randomized controlled trial of combination budesonide/form...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
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Elsevier
2013
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| Online Access: | https://eprints.nottingham.ac.uk/42813/ |
| _version_ | 1848796574180704256 |
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| author | Patel, Mitesh Pilcher, Janine Munro, Claire Hosking, Alexander Pritchard, Alison Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard |
| author_facet | Patel, Mitesh Pilcher, Janine Munro, Claire Hosking, Alexander Pritchard, Alison Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard |
| author_sort | Patel, Mitesh |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
The relationship between current asthma symptoms and rescue bronchodilator (reliever) use is uncertain, leading to different recommendations about the preferred reliever metric to use when assessing asthma control. In a 6-month randomized controlled trial of combination budesonide/formoterol as maintenance and reliever therapy versus combination budesonide/formoterol as maintenance treatment with albuterol as reliever, we measured inhaler use by electronic monitoring.
Objective
To determine the agreement between current asthma symptoms and different metrics of albuterol use for patients randomly assigned to maintenance budesonide/formoterol treatment.
Methods
Data on albuterol use were extracted for the 7-day period before visit 2 (at week 3) from 150 adult patients with asthma. Current asthma symptoms were measured by Asthma Control Questionnaire-5 (ACQ-5) score at the clinic visit.
Results
The number of days of albuterol use, the average number of albuterol actuations/day, and the highest number of albuterol actuations/day in the 1-week period were all positively associated with ACQ-5 score (r = 0.41-0.45, P < .001) and had moderate discrimination for well-controlled and not well-controlled asthma (ACQ-5 scores ≤0.75 and ≥1.5, respectively), with receiver operator characteristic area under the curve of 0.80 to 0.82 and 0.70 to 0.77, respectively. Cut points of ≥3 days of albuterol use, average albuterol use of ≥1 actuation/day, and highest albuterol use of ≥4 actuations/day in the 1-week period had 73% sensitivity and 62% specificity, 78% sensitivity and 67% specificity, and 78% sensitivity and 66% specificity, respectively, for predicting an ACQ-5 ≥1.5.
Conclusion
Our findings support the use of the number of days of albuterol use, the average number of albuterol actuations per day, and the highest number of albuterol actuations per day over a 1-week period of observation as comparable markers of current asthma control. |
| first_indexed | 2025-11-14T19:50:09Z |
| format | Article |
| id | nottingham-42813 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:50:09Z |
| publishDate | 2013 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-428132020-05-04T16:37:35Z https://eprints.nottingham.ac.uk/42813/ Short-acting β-agonist use as a marker of current asthma control Patel, Mitesh Pilcher, Janine Munro, Claire Hosking, Alexander Pritchard, Alison Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard Background The relationship between current asthma symptoms and rescue bronchodilator (reliever) use is uncertain, leading to different recommendations about the preferred reliever metric to use when assessing asthma control. In a 6-month randomized controlled trial of combination budesonide/formoterol as maintenance and reliever therapy versus combination budesonide/formoterol as maintenance treatment with albuterol as reliever, we measured inhaler use by electronic monitoring. Objective To determine the agreement between current asthma symptoms and different metrics of albuterol use for patients randomly assigned to maintenance budesonide/formoterol treatment. Methods Data on albuterol use were extracted for the 7-day period before visit 2 (at week 3) from 150 adult patients with asthma. Current asthma symptoms were measured by Asthma Control Questionnaire-5 (ACQ-5) score at the clinic visit. Results The number of days of albuterol use, the average number of albuterol actuations/day, and the highest number of albuterol actuations/day in the 1-week period were all positively associated with ACQ-5 score (r = 0.41-0.45, P < .001) and had moderate discrimination for well-controlled and not well-controlled asthma (ACQ-5 scores ≤0.75 and ≥1.5, respectively), with receiver operator characteristic area under the curve of 0.80 to 0.82 and 0.70 to 0.77, respectively. Cut points of ≥3 days of albuterol use, average albuterol use of ≥1 actuation/day, and highest albuterol use of ≥4 actuations/day in the 1-week period had 73% sensitivity and 62% specificity, 78% sensitivity and 67% specificity, and 78% sensitivity and 66% specificity, respectively, for predicting an ACQ-5 ≥1.5. Conclusion Our findings support the use of the number of days of albuterol use, the average number of albuterol actuations per day, and the highest number of albuterol actuations per day over a 1-week period of observation as comparable markers of current asthma control. Elsevier 2013-06-05 Article PeerReviewed Patel, Mitesh, Pilcher, Janine, Munro, Claire, Hosking, Alexander, Pritchard, Alison, Shaw, Dominick, Black, Peter, Weatherall, Mark and Beasley, Richard (2013) Short-acting β-agonist use as a marker of current asthma control. Journal of Allergy and Clinical Immunology: In Practice, 1 (4). pp. 370-377. ISSN 2213-2201 ACQ Albuterol Asthma Control Electronic Metered-dose inhaler Monitoring Questionnaire Reliever Symptoms http://www.sciencedirect.com/science/article/pii/S2213219813002122 doi:10.1016/j.jaip.2013.04.008 doi:10.1016/j.jaip.2013.04.008 |
| spellingShingle | ACQ Albuterol Asthma Control Electronic Metered-dose inhaler Monitoring Questionnaire Reliever Symptoms Patel, Mitesh Pilcher, Janine Munro, Claire Hosking, Alexander Pritchard, Alison Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard Short-acting β-agonist use as a marker of current asthma control |
| title | Short-acting β-agonist use as a marker of current asthma control |
| title_full | Short-acting β-agonist use as a marker of current asthma control |
| title_fullStr | Short-acting β-agonist use as a marker of current asthma control |
| title_full_unstemmed | Short-acting β-agonist use as a marker of current asthma control |
| title_short | Short-acting β-agonist use as a marker of current asthma control |
| title_sort | short-acting β-agonist use as a marker of current asthma control |
| topic | ACQ Albuterol Asthma Control Electronic Metered-dose inhaler Monitoring Questionnaire Reliever Symptoms |
| url | https://eprints.nottingham.ac.uk/42813/ https://eprints.nottingham.ac.uk/42813/ https://eprints.nottingham.ac.uk/42813/ |