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Running head: ASTHMA

Asthma
Salena Barnes
Georgia College and State University

Running head: ASTHMA

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Asthma

According to the National Heart Lung and Blood Institute (2014)over 25 million people
suffer from asthma in the United States. Asthma s defined as a long-term lung disease in which
the airways are narrowed and inflammed. Common symptoms of asthma patients consist of:
wheezing, shortness of breath, coughing, and chest tightness. In most people diagnosed with
asthma, it begins in childhood and currently there is no cure for asthma. Yet the disease is
managable with proper treament. Beginning treatment as soon as an exacerbation occurs is very
important in order to prevent a severe asthma attack, which could be fatal (National Heart Lung
and Blood Institute, 2014).
Furthermore, the aim of the study being examined focused on comparing the use of
assessment tools consisting of the Asthma APGAR system and the Asthma Control Test
(ACT)/Childhood Asthma Control Test (CACT) in order to adequately assess whether ones
asthma is under control (Rank, Bertram, Wollan, Yawn, & Yawn, 2014). The Asthma APGAR
system tool was developed by primary care clinicians in which an algorithm and patientcompleted questionnaire is used to guide the patients asthma treatment plan. The patientcompleted questionnaire focus on evaluating poor asthma control which includes the assessment
of: known triggers, unrecognized exposures, incorrect inhaler use technique, lack of adherance to
therapy as prescrbed, and misdiagnosed asthma. On the other had, the ACT/CACT was a tool
developed by asthma specialist. It is not widely used due to no guidance in asthma treatment.
This randomized pragmated controlled trial of a multicenter was used in the primary care
practices to evaluate the effectivemens of the Asthma APGAR system (Rank et al., 2014).
Therefore, the results concluded that their was no significant difference in the direction of
disagreement amongst two assessment tools (McNemar Test p=0.35) (Rank et al., 2014). The

Running head: ASTHMA

overall agreement amongst the assessment tool resulted in a kappa value of 0.68 (84.4% of
participants were in substantial agreement). Out of the 468 participants, 306 were classified as
not controlled by the Asthma APGAR sytem and the ACT/CACT. Using the Asthma APGAR
system to evaluate the patients with poor asthma control: 73 patients had no controller
medications, 234 patients were seldomly able to avoid triggers, and 116 patients stated that they
did not use their precribed controller on a daily bases. In more than 75% of patient participating
in the study, the Asthma APGAR system helped link poor asthma control with poor management
strategies (Rank et al., 2014).
This can be applied to clinical practice because it examines the importance of conducting
a thorough assessment in the clinical setting on patients experiencing poor asthma control in
order to rule out poor management techniques before changing their medication regimen.
Moreover, recognition of inadequate techniques can decrease exacerbations, hospital admissions,
reduce complications associated with asthma and enhance positive patient outcomes.

Running head: ASTHMA

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References

National Heart Lung and Blood Institute. (2014). What is asthma. from
http://www.nhlbi.nih.gov/health/health-topics/topics/asthma
Rank, M. A., Bertram, S., Wollan, P., Yawn, R. A., & Yawn, B. P. (2014). Comparing the asthma
apgar system and the asthma control test in a multicenter primary care sample. Mayo Clin
Proc, 89(7), 917-925. doi: 10.1016/j.mayocp.2014.02.016