Respiratory Institute Outcomes
Asthma Control Test Scores During Visits in 2018
Asthma control can be formally assessed by using validated instruments, including the Asthma Control Test™ (ACT). The ACT includes 5 questions that assess daytime symptoms, nighttime symptoms, reliance on as-needed “rescue” medication, the effect of asthma on everyday functioning, and patient assessment of control, with each of these 5 responses scored on a 1 to 5 scale. Higher scores reflect improved asthma control, a major objective of asthma management.
The ACT has been routinely used at Cleveland Clinic’s Asthma Center for more than a decade. All asthma patients complete the ACT when seen at initial and follow-up visits.
The 2018 data are being reported in the context of a quality measure. The American Academy of Allergy, Asthma, and Immunology Qualified Clinical Data Registry (QCDR),¹⁻² which has been approved by Centers for Medicare and Medicaid Services, qualifies as a reporting tool for the Merit-based Incentive Payment System (MIPS).² The measure addresses the proportion of asthma patients whose asthma was either poorly or not well controlled, as indicated by an ACT score < 20 at baseline, who achieve an improvement of ≥ 3 at a subsequent visit during a 12-month period. An increase of 3 has been shown to be the minimal important difference for the ACT. ³
Improvement in ACT Scores for Patients With Poorly or Not Well Controlled Asthma at Initial Visit (N = 829)
ACT = Asthma Control Test
ᵃ A change in score of 3 represents the minimal important difference
ᵇ A score of 19 indicates good control