Variation of Asthma Symptoms Perception
Background: Asthmatic patients may perceive their symptoms inadequately putting them at a risk of a fatal attack because the severity of an exacerbation may be underestimated. The present study is intended to detect if disease duration affects the perception of asthma symptoms. The relation between asthma activity and evaluation methods commonly used in clinical practice, like presence of symptoms and asthma control test (ACT), was evaluated.
Methods: The study involved 100 asthma patients with ages less than 40 years. Presence of symptoms, ACT score and spirometry were recorded to assess asthma activity at the time of examination. Cross tabulation of patients groups was used to screen for significant differences in the means using analysis of variance.
Results: ACT score was higher while National Asthma Education and Prevention Program (NAEPP) class was lower in symptoms free compared with symptomatic asthmatic patients (P = 0.000 and 0.005 respectively). ACT score correlated negatively, while NAEPP correlated positively with age implying that asthma severity increases with age (CC = 0.41, P = 0.000 and CC = 0.28, P = 0.007). Asthma duration was significantly higher in well controlled compared with both poorly controlled and uncontrolled asthmatic patients (P = 0.000 for both). 5.7% of asymptomatic patients were suffering from severe persistent asthma and 24.5% from moderate persistent asthma according to NAEPP classification.
Conclusion: Presence or absences of symptoms sometimes does not indicate asthma severity. Clinicians must therefore pay attention when comparing groups of asthma patients for whom severity categorization is largely based on symptomatology.
Keywords: spirometry, NAEPP, lung function.