Association Between Asthma Control Tests and Lung Function Parameters Among Asthma Patients in a Tertiary Care Setting

Abstract

Background: Asthma is a chronic inflammatory airway disease characterized by reversible airflow limitation and variable respiratory symptoms. Monitoring asthma control using patient-reported tools like the Asthma Control Test (ACT) alongside objective lung function assessment such as spirometry (FEV₁) is essential to optimize therapy, particularly in tertiary care settings.

Objectives: To assess the correlation between ACT scores and lung function parameters (FEV₁ % predicted) among adult asthma patients attending a tertiary care hospital and to analyze their distribution according to asthma control status.

Methods: This cross-sectional study included 125 adult asthma patients diagnosed as per Global Initiative for Asthma (GINA) guidelines. ACT scores were recorded to categorize patients into well-controlled (ACT ≥20) and poorly controlled (ACT <20) asthma groups. Spirometry was performed to measure FEV₁ and classify obstruction severity. Correlations between ACT scores, FEV₁ % predicted, and quality of life (QOL) measures were analyzed using Pearson correlation coefficients.

Results: Among the 125 patients (mean age distribution: 46.4% aged 18–39, 53.6% male), 54.4% were well-controlled and 45.6% poorly controlled by ACT criteria. Lung function assessment showed 12% with normal FEV₁, 56% with mild obstruction, 16.8% moderate, and 15.2% severe. A strong positive correlation was observed between ACT scores and FEV₁ % predicted (r = 0.752; p < 0.001). ACT scores also showed a moderate correlation with quality of life (r = 0.271; p = 0.002), and quality of life correlated moderately with FEV₁ % predicted (r = 0.567; p = 0.001). The majority of patients reported mild to severe impairments in symptom, activity, emotional functioning, and environmental domains.

Conclusion: The study demonstrates a significant positive correlation between ACT scores and lung function parameters, supporting the complementary roles of patient-reported outcomes and spirometry in asthma monitoring. Integrating ACT assessment with spirometric evaluation can enhance personalized management and improve outcomes in tertiary care settings, especially in resource-limited environments.