Questionnaires for patients with bronchial asthma as a method of control and diagnosis

A questionnaire for interviewing patients with bronchial asthma allows you to efficiently, cheaply, and most importantly, quickly collect and adequately assess information, this is especially important for a doctor when it comes to admitting patients to a polyclinic.

There is little time to determine the severity of the disease and amend the treatment, and a person with this disease requires special attention to prevent dangerous complications and even disability and death.

The importance of controlling bronchial asthma

According to epidemiological studies, the number of patients with diagnosed bronchial asthma is growing from year to year. Modern medicine has made great strides in studying the processes of the onset of this disease, in the early detection of the first symptoms, in the use of modern effective medicines and preventive methods, but mortality from it is increasing. This is due to the following reasons:

  • inadequate assessment by patients of the severity of their disease;
  • irregular drug intake;
  • partial or complete failure to comply with the recommendations of the attending physician;
  • improper technique of using inhaled drugs.

But asthma can be successfully treated and completely controlled, i.e. practically do not experience unpleasant symptoms either day or night, do not take fast-acting drugs to relieve an attack, and even live fully, without restrictions, like people with a healthy respiratory system.

In other words, control is the ultimate goal of therapy, when, as a result of the painstaking work of the doctor and the patient, it is possible to achieve good health with a minimum of drugs.

Control methods

Over the course of one person’s life, asthma symptoms may disappear and reappear, so a stepwise approach to treatment has been developed in which the intensity of medication increases as the severity of the disease increases.

An asthmatic should always take the basic drug, as a rule, these are hormonal drugs with an anti-inflammatory effect (inhaled glucocorticosteroids ). When the dose of drugs worsens, they add drugs with a different mechanism of action, and when they improve, they are removed. The goal of treatment is to achieve control over the course of bronchial asthma. 

But the concept of control is multifaceted, and for a long time there was no single objective method for assessing it. This led to the development of many diagnostic systems that take into account the symptoms of bronchial asthma, nocturnal attacks and their number, the history of the development of the disease (questionnaires, questionnaires), the assessment of laboratory results and respiratory function indicators obtained by peak flowmetry , spirometry.

Apparatus methods for assessing the functioning of the respiratory system are used mainly for diagnosing asthma; they are not suitable for daily monitoring, since they are difficult to execute, inaccessible to children under 5 years of age. Their indicators may be distorted while taking bronchodilator drugs.

Survey of patients with bronchial asthma

The asthma questionnaire has become a more promising option, and a large number of them have been published since 2008. The most widely used are the AST control test ( Astma Control Test ) and the ACQ-5 ( Asthma Control Questionnaire ) questionnaire . They have slight differences.

ACQ-5 does not contain questions about the use of fast-acting drugs that relieve bronchospasm, therefore, its results may be somewhat overestimated. Its advantage over AST is the ability to predict the number of exacerbations in a patient in the coming year and change treatment in advance.

To assess the level of disease control

To assess the level of control, a simple AST test is convenient, which the patient can pass himself and adequately assess his status. It is convenient to carry out it at any time of the day, at work, at home or in the clinic. It comes in two forms: for adults and for children. Leading pulmonary centers have approved AST for use in medical practice.

The questionnaire on bronchial asthma has proven its reliability: the test results coincide with the patient’s condition assessed by a pulmonologist and with spirometry data. And if it shows that the patient’s condition is unsatisfactory, then a doctor’s consultation is necessary for the timely correction of therapy.

For diagnostic purposes

Additional questions may be asked by the physician for diagnostic purposes. So in the report by the working group GINA (Global Initiative on Bronchial Asthma) a simple study was proposed. It is necessary to ask questions of the patient with asthma about his state of health during the last month:

  1. Are daytime asthma attacks more frequent than 2 times a week?
  2. Have there been nighttime asthma attacks?
  3. Have you taken fast-acting medications more than twice a week?
  4. Are you experiencing limited physical activity?

The results are interpreted as follows:

  • controlled bronchial asthma, if the answer is “no” to all questions. The treatment remains the same;
  • partially controlled, if the answer is “yes” to 1-2 questions. It is possible to make some changes in the regimen or dosage of drugs;
  • uncontrollable if positive answers to 3-4 questions. An urgent correction of the basic therapy is required, the patient may be hospitalized.

Questionnaire methodology and evaluation of results

If you are in doubt whether your asthma is under control, answer the AST questionnaire yourself. The test can be easily found on the Internet or from your doctor. There are separate options for children and adults. The test procedure is simple and straightforward.

The questionnaire consists of 5 questions, for each of which you need to choose one of the proposed answer options. For answers, points are awarded from 1 to 5, which are eventually summed up. By the number of points scored, you can evaluate data on the course of the disease for the last 4 weeks.

  • 25 points – asthma is completely controlled.
  • 20-24 points – well controlled.
  • Less than 20 points – asthma is poorly controlled, it is necessary to consult a medical specialist to change the treatment regimen and prevent the development of possible complications.

Finally

Bronchial asthma is incurable, but you can live with it fully, without asthma attacks and difficulty breathing, if you control your disease. Questioning asthmatics allows to timely identify exacerbation of bronchial asthma, prevent the development of dangerous complications.

The success of treatment will depend not only on the implementation of medical recommendations and medication intake, but also on the level of awareness of the characteristics of the disease. You need to get useful information from reliable sources (medical literature, specialized websites).

event_note February 26, 2021

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