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Assessing Asthma Control with Clinical Outcome Assessments

Although the healthcare community has made significant progress in understanding its pathophysiology and developing beneficial treatments to manage it, asthma remains a common condition linked with high mortality and social and economic effects.1 The symptoms of asthma, from chest tightness and shortness of breath to coughing and wheezing, can impact the everyday life of those diagnosed with this chronic lung disease.
When the National Heart, Lung, and Blood Institute (NHLB) shared updated guidelines for asthma management, its evidence-based recommendations created a shift in the way healthcare providers, specialists, researchers and patients approach asthma care. With much of asthma’s burden credited to the challenge of helping people handle their uncontrolled asthma, the industry began focusing less on navigating the severity of the condition and more on simply controlling it. This paradigm shift has changed the decision-making process for healthcare professionals in the evaluation, treatment and management of asthma.
Now, a greater focus has been placed on controlling the current impairment and future risk of patients, which may consist of treating their day-to-day symptoms, addressing their level of activity, facilitating their use of relievers, improving their quality of life, preventing permanent lung function damage, examining exacerbation risks and managing any negative effects of treatment.1
Why Control Asthma with COAs
Managing asthma for patients as a primary care provider or specialist can be difficult, but there are several tools at your disposal that can offer a more complete picture of patient health statuses to improve care delivery. Clinical outcome assessments (COAs) that come in the form of surveys, questionnaires, diaries and rating scales act as reliable and efficient instruments in evaluating and enabling better asthma control for patients of all ages. The data collected from disease-specific patient-reported outcome (PRO) and observer-reported outcome (ObsRo) measurements can help build a detailed profile of a condition’s trajectory based on patients’ real lived experiences from their own point of view.
A simple COA questionnaire for asthma patients can support a variety of aims, from designing multifaceted asthma screening procedures to assessing asthma symptoms in the office or remotely, with or without additional lung functioning measures like spirometry. Healthcare professionals can also more easily identify known allergic and non-allergic environmental triggers that exacerbate patients’ symptoms with a PRO or ObsRo asthma control test questionnaire. By asking patients if certain triggers currently worsen their symptoms and whether they have been successful in avoiding them, you may encourage patients to increase their awareness of such environmental stimuli. Information from COA measurements can prove useful in communicating with providers and specialists and finding the most appropriate treatment or therapy for unique patient experiences.
Gathering meaningful insights from the patient’s perspective through clinical outcome assessments is a strategy that more clinicians should adopt to inform critical decisions in the asthma management stage, once diagnoses are achieved. Limiting patient evaluations to observed physiologic markers and symptoms means overlooking other key factors, such as the impact of asthma on functioning and role performance.2 COA surveys are also easy to administer and collect, with completion times for many asthma control tests around one to two minutes—something that busy clinics and practices would appreciate.
Examples of Effective Asthma Surveys
A range of asthma surveys and tests exist to measure patient health along the path toward asthma management in clinical care and research applications. QualityMetric’s suite of disease-specific clinical outcome assessments includes four proven solutions for asthma developed with guidance from asthma specialists: an ACT test asthma questionnaire and optional test with triggers, an ACT for caregivers, an asthma impact survey and a pediatric asthma impact assessment.
QualityMetric’s Asthma Surveys

  • The Asthma Control Test™ (ACT™): A five-item PRO asthma measure that assesses the impairment domain of asthma control as defined by the NHLB in individuals aged twelve and older. The ACT-T version offers a list of environmental triggers that exacerbate symptoms.
  • The Asthma Control Test™ – Caregiver: A five-item ObsRo asthma survey completed by caregivers for children ages five to eleven. Measures asthma control, with or without lung functioning measures like spirometry.
  • The Asthma Impact Survey™ (AIS-6™): A six-item PRO asthma survey that considers the burden of asthma as it impacts daily activity performance, social and emotional functioning and productivity in personal or professional life.
  • The Pediatric Asthma Impact Survey (PAIS-6™): A six-item ObsRo test for asthma control initiatives completed by parents of children ages five to seventeen. Takes one to two minutes to complete and measures the broad impact of asthma specifically for pediatric patients.

To make the most of these asthma control tests, consider working with QualityMetric to develop translations, interpret results and reach meaningful conclusions about patient health outcomes. QualityMetric offers all survey licensees standardized scoring services and technologies as well as translation and interpretation guidance.
Browse our suite of health surveys to learn more about COA solutions for measuring patient outcomes and explore their use in your research or clinical practice.

  1. Alzahrani, YA, Becker, EA. Asthma control assessment tools. Respiratory Care. 2016;61(1):106-116.
  2. Nathan, RA, Development of the asthma control test. The Journal of Allergy and Clinical Immunology. 2004;113(1):59-65.