Internet-Based Survey Identifies Patients With Labile Asthma Control

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Patients who had higher asthma control test score variability were more likely to have severe asthma.
Patients who had higher asthma control test score variability were more likely to have severe asthma.

An Internet-based Monitoring Systems (IBS) survey developed to facilitate monitoring of asthma symptoms and exacerbations has identified a specific subgroup of patients with asthma with highly variable asthma control and unmet treatment needs, according to an article published in CHEST

The IBS survey was part of the Severe Asthma Research Program (SARP) that invited 528 adults in the SARP III cohort to complete a monthly IBS asthma control survey. A total of 259 patients participated. Compared with individuals who did not participate, individuals who did were older and more likely to be white, college educated, have a higher income, and have controlled asthma.


Kelly Wong-McGrath, MS, of the division of pulmonary and critical care medicine, department of medicine, and the Cardiovascular Research Institute, University of California, San Francisco, and colleagues noted that among these participants, the subgroup with the highest asthma control test (ACT) score variability was more likely to have severe asthma, lower ACT scores at baseline, and increased asthma-related healthcare utilization, which was often caused by cold and flu-like illnesses. Participants with high ACT variability were also more likely to be obese and have hypertension and metabolic dysfunction.


The survey also showed that active participation with an internet-based symptom survey tool was influenced by race, socioeconomic status, and asthma control. The investigators felt that the association between asthma lability, increased susceptibility to adverse asthma effects of cold and flu-like illnesses, and metabolic dysfunction points to potential interventions. Furthermore, they note that IBS can potentially identify patients at risk for asthma exacerbations and enable providers to target interventions such as higher inhaled corticosteroid doses to prevent future exacerbations.


Wong-McGrath K, Denlinger LC, Bleecker ER, et al. Internet-based monitoring in the Severe Asthma Research Program identifies a subgroup of patients with labile asthma control [published online October 26, 2017]. CHEST. doi:10.1016/j.chest.2017.10.017

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