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For Health Care Professionals
Questions
- How is the ATAQ instrument administered?
- What is measured by the Control Domain of the ATAQ instrument?
- What other domains are measured in the ATAQ Complete instrument?
- What do the updated NHLBI asthma guidelines say about use of self-assessment tools, including the ATAQ instrument?
- How does the ATAQ instrument on this Web site differ from that in the NHLBI guidelines?
- What aspects of asthma management are not addressed by the ATAQ instrument?
- How is the ATAQ instrument scored?
- Are the ATAQ instruments on this Web site the same as those used in the ATAQ validation studies?
- Where can I find information regarding the validation studies?
- Is the ATAQ instrument copyrighted?
- May I use the ATAQ instrument in scientific presentations?
- Where can health care providers and managed care organizations get more information about the ATAQ instrument?
Answers
How is the ATAQ instrument administered?
The ATAQ instrument can be either self-administered or administered by a health care professional. In the validation studies, patients received the ATAQ Complete instrument through the mail and self-administered the questionnaire. Patients who did not complete the questionnaire received a follow-up phone call, and some of these individuals completed the questionnaire by phone.
The ATAQ instrument for adults is designed for patients aged 18 years or older. The ATAQ instrument for children and adolescents is designed for patients aged 5 to 17 years and can be completed by a parent or other designated caregiver.
What is measured by the Control Domain of the ATAQ instrument?
The ATAQ instrument highlights potential asthma management issues, such as self-reported asthma symptom control, missed daily activities, missed work and/or school, nocturnal awakenings, and high use of quick-reliever medication. For children, wheeze during the day when exercising and when not exercising are also assessed.
What other domains are measured in the ATAQ Complete instrument?
Other domains include the Communication Domain, the Behavior/Attitude Domain, the Self-Efficacy Domain, and the Knowledge Domain. Questions for these domains are not currently included in the interactive questionnaire on this Web site.
What do the updated NHLBI asthma guidelines say about use of self-assessment tools, including the ATAQ instrument?
The guidelines recommend the use of validated self-assessment tools to help determine whether asthma is well controlled from the perspective of the patients themselves and/or their families in patients aged 12 years and older.
This may be done by using a periodic self-assessment form, such as the ATAQ instrument, which may be filled out at the time of follow-up visits to the clinician. NHLBI guidelines recommend ATAQ as one of the validated methods for assessing asthma control in patients aged 12 years and older, and classify ATAQ scores as follows:
0=asthma is well controlled.
1–2=asthma is not well controlled.
3–4=asthma is poorly controlled.
The guidelines also note that patients and parents are more likely to appreciate tools like ATAQ if they receive feedback from the clinician who helps them recognize the value of self-monitoring.
How does the ATAQ instrument on this Web site differ from that in the NHLBI guidelines?
This site contains 2 interactive versions of the ATAQ Control instrument: one scientifically validated for adults aged 18 years and older, and the other scientifically validated for children and teens aged 5 to 17 years. The NHLBI guidelines recommend the adult version of the ATAQ Control instrument for patients aged 12 years and older.
The ATAQ Control instrument reproduced in the guidelines has been adapted from the original with modified wording, order, and scoring of questions. For instance, the guidelines version does not include the Unsure option, whereas the original validated questionnaire scores the Unsure response as an indicator of a potential asthma management problem and may prompt even those patients who are uncertain about their level of asthma control to consult their physician.
The scoring for the quick-relief medication on this site reflects a lower threshold than was used in the guidelines and the ATAQ validation studies to identify potential control problems. This modification was designed to encourage patients and providers to discuss how asthma medications are being used.
What aspects of asthma management are not addressed by the ATAQ instrument?
The ATAQ instrument and similar survey tools do not identify patients who may be at immediate risk of therapeutic failure. They are not designed to categorize a patient’s level of asthma severity, and they should not replace peak expiratory flow monitoring or physician office visits. In addition, they will not identify patients who self-report no control problems but who are not being treated in accordance with current asthma guidelines.
How is the ATAQ instrument scored?
For each completed ATAQ Complete survey, a score of 0 on the Control Issues domain indicates no control issues, as measured by the instrument in the past 4 weeks. For adults, the maximum score of 4 indicates that all control issues measured by the instrument were present in the past 4 weeks. For children and adolescents, the maximum score of 7 indicates that all control issues measured by the instrument were present in the past 4 weeks. Note: The same scoring for the Control Issues domain applies to each completed ATAQ Control survey.
For the Other Issues domain in the ATAQ Complete survey, a score of 0 suggests that gaps and barriers to self-management are absent. A score a 1 or more indicates the presence and nature of gaps and/or barriers.
Before using the ATAQ instrument for asthma disease management, review the thresholds of the scoring algorithm and determine their potential impact on classification of patients.
Are the ATAQ instruments on this Web site the same as those used in the ATAQ validation studies?
The ATAQ Complete instrument, available as a downloadable PDF on this page, was administered in the ATAQ validation studies. The ATAQ Control instrument is one portion of the ATAQ Complete instrument.
The scoring for the quick-relief medication reflects a lower threshold than was used in the ATAQ validation studies to identify potential control problems. This modification was designed to encourage patients and providers to discuss how asthma medications are being used.
Where can I find information regarding the validation studies?
Key references for the ATAQ instrument for adults:
- Vollmer WM, Markson LE, O’Connor E, et al. Association of asthma control with health care utilization and quality of life. Am J Respir Crit Care Med. 1999;160:1647–1652.
- Markson LE, Vollmer WM, Fitterman L, et al. Insight into patient dissatisfaction with asthma treatment. Arch Intern Med. 2001;161:379–384.
- Vollmer WM, Markson LE, O’Connor E, Frazier EA, Berger M, Buist AS. Association of asthma control with health care utilization: a prospective evaluation. Am J Respir Crit Care Med. 2002;165:195–199.
- Peters D, Chen C, Markson LE, Allen-Ramey FC, Vollmer WM. Using an asthma control questionnaire and administrative data to predict health-care utilization. Chest. 2006;129:918–924.
Key reference for the ATAQ instrument for children and adolescents:
- Skinner EA, Diette GB, Algatt-Bergstrom PJ, et al. The Asthma Therapy Assessment Questionnaire (ATAQ) for children and adolescents. Dis Manag. 2004;7:305–313.
Articles that describe potential application of the ATAQ instrument:
- US Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma: Full Report 2007. NIH publication 07-4051. www.nhlbi.nih.gov/guidelines/asthma/index.htm. Accessed January 28, 2009.
- Algatt-Bergstrom PJ, Markson LE, Murray RK, Berger ML. A population-based approach to asthma disease management. Dis Manag Health Outcomes. 2000;7:179–186.
- Burton WN, Schultz AB, Connerty CM, Chen C-Y, Edington DW. Asthma disease management: a worksite-based asthma education program. Dis Manag. 2001;4:3–13.
Is the ATAQ instrument copyrighted?
Yes. If you reprint any of the material contained in the ATAQ instrument, the following statement must be included:
Copyright © 2009 Merck & Co., Inc. Whitehouse Station, NJ 08889, USA. All rights reserved.
May I use the ATAQ instrument in scientific presentations?
The instrument may be described in scientific presentations or publications; however, because of copyright restrictions, please refrain from presenting the ATAQ questions verbatim.
Where can health care providers and managed care organizations get more information about the ATAQ instrument?
Please contact the local Merck Medical Services office. In the United States, please contact the Merck National Service Center at 800-609-4618, available Monday through Friday from 8 AM to 7 PM ET.
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