Assessing asthma control in routine clinical practice: use of the Royal College of Physicians '3 questions'

01 Jun 2009

AIMS

To evaluate the Royal College of Physicians (RCP) '3 questions' in the assessment of asthma control.

METHODS

This was a prospective observational study. Subjects (20 adults and 15 children) were assessed 2-weekly over 12 weeks, with data collection on RCP scores (yes/no for each question, 0-3), lung function, asthma control questionnaire (ACQ), asthma quality of life questionnaires (AQLQ), bronchodilator use, and exhaled nitric oxide level.

RESULTS

Between-subject analysis showed that the RCP score correlated strongly with the ACQ (correlation coefficient 0.79, p<0.001), AQLQ (-0.71, p=0.001) and bronchodilator use (0.52, p=0.02) in adults, although in children the correlations were weaker and nonsignificant. Within-subject analysis showed strong correlations between changes in the RCP score and ACQ score in adults (0.67, p<0.001) and children (0.61, p<0.001), between quality of life scores in adults (-0.67, p<0.001) and children (-0.69, p<0.001), and changes in bronchodilator use in adults (0.49, p<0.001) and children (0.48, p<0.001). Weaker or absent correlations existed with lung function and no correlations with exhaled nitric oxide levels. An RCP score of 1 or more identified 89% of occasions when the ACQ was >1.

CONCLUSIONS

The RCP 3 questions reliably quantify current asthma control in this dataset, with a negative response to all 3 questions indicating good control. These data support the use of the 3 questions, but larger validation studies are needed.

Resource information

Respiratory conditions
  • Asthma
Respiratory topics
  • Disease management
Type of resource
Peer-reviewed article
Author(s)
Thomas M, Gruffydd-Jones K, Stonham C, Ward S, Macfarlane TV