Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/10271
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Clinical implications of the Royal College of Physicians three questions in routine asthma care: A real-life validation study
Authors: Pinnock, Hilary
Burton, Chris
Campbell, Stephen
Gruffydd-Jones, Kevin
Hannon, Kerin
Hoskins, Gaylor
Lester, Helen
Price, David
Contact Email: gaylor.hoskins@stir.ac.uk
Keywords: Asthma control
asthma reviews
primary care
Royal College of Physicians three questions
validation
Issue Date: Sep-2012
Publisher: The Primary Care Respiratory Society
Citation: Pinnock H, Burton C, Campbell S, Gruffydd-Jones K, Hannon K, Hoskins G, Lester H & Price D (2012) Clinical implications of the Royal College of Physicians three questions in routine asthma care: A real-life validation study, Primary Care Respiratory Journal, 21 (3), pp. 288-294.
Abstract: BACKGROUND: Annual recording of the Royal College of Physicians three questions (RCP3Q) morbidity score is rewarded within the UK 'pay-for-performance' Quality and Outcomes Framework. AIMS: To investigate the performance of the RCP3Qs for assessing control in real-life practice compared with the validated Asthma Control Questionnaire (ACQ) administered by self-completed questionnaire. METHODS: We compared the RCP3Q score extracted from a patient's computerised medical record with the ACQ self-completed after the consultation. The anonymous data were paired by practice, age, sex, and dates of completion. We calculated the sensitivity and specificity of the RCP3Q scale compared with the threshold for good/poor asthma control (ACQ greater than 1). RESULTS: Of 291 ACQ questionnaires returned from 12 participating practices, 129 could be paired with complete RCP3Q data. Twenty-five of 27 patients who scored zero on the RCP3Q were well controlled (ACQ less than 1). An RCP3Q score greater than 1 predicted inadequate control (ACQ greater than 1) with a sensitivity of 0.96 and specificity of 0.34. Comparable values for RCP3Q greater than 2 were sensitivity 0.50 and specificity 0.94. The intraclass correlation coefficient of 0.13 indicated substantial variability between practices. Exacerbations and use of reliever inhalers were moderately correlated with ACQ (Spearman's rho 0.3 and 0.35) and may reflect different aspects of control. CONCLUSIONS: In routine practice, an RCP3Q score of zero indicates good asthma control and a score of 2 or 3 indicates poor control. An RCP3Q score of 1 has good sensitivity but poor specificity for suboptimal control and should provoke further enquiry and consideration of other aspects of control such as exacerbations and use of reliever inhalers.
Type: Journal Article
URI: http://hdl.handle.net/1893/10271
DOI Link: http://dx.doi.org/10.4104/pcrj.2012.00052
Rights: Publisher allows this work to be made available in this repository. Published in Primary Care Respiratory Journal by The Primary Care Respiratory Society: Available with permission of the editors, Primary Care Respiratory Journal - Pinnock H, Burton C, Campbell S, Gruffydd-Jones K, Hannon K, Hoskins G, Lester H, Price D. Clinical implications of the Royal College of Physicians three questions in routine asthma care: a real-life validation study. Prim Care Respir J 2012,21(3):288-294. DOI: http://dx.doi.org/10.4104/pcrj.2012.00052
Affiliation: University of Edinburgh
University of Edinburgh
University of Manchester
University of Bath
University of Manchester
NMAHP Research
University of Birmingham
University of Aberdeen

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