Relationship Between Asthma Control as Measured by the Asthma Impairment and Risk Questionnaire (AIRQ) and Patient Perception of Disease Status, Health-Related Quality of Life, and Treatment Adherence

Joan Reibman; Bradley E Chipps; Robert S Zeiger; David A Beuther; Robert A Wise; William McCann; Ileen Gilbert; James M Eudicone; Hitesh N Gandhi; Gale Harding; Katelyn Cutts; Karin S Coyne; Kevin R Murphy; Maureen George

doi:10.2147/JAA.S373184

Relationship Between Asthma Control as Measured by the Asthma Impairment and Risk Questionnaire (AIRQ) and Patient Perception of Disease Status, Health-Related Quality of Life, and Treatment Adherence

J Asthma Allergy. 2023 Jan 5:16:59-72. doi: 10.2147/JAA.S373184. eCollection 2023.

Authors

Affiliations

¹ New York University School of Medicine, New York, NY, USA.
² Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA.
³ Department of Clinical Science Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
⁴ National Jewish Health, Denver, CO, USA.
⁵ Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Allergy Partners, Asheville, NC, USA.
⁷ BioPharmaceuticals Medical, AstraZeneca, Wilmington, DE, USA.
⁸ Evidera, Bethesda, MD, USA.
⁹ Boys Town National Research Hospital, Boys Town, NE, USA.
¹⁰ Office of Research & Scholarship, Columbia University School of Nursing, New York, NY, USA.

Abstract

Purpose: Critical asthma outcomes highlighted in clinical guidelines include asthma-related quality of life, asthma exacerbations, and asthma control. An easy-to-implement measure of asthma control that assesses both symptom impairment and exacerbation risk and reflects the impact of asthma on patients' lives is lacking. Hence, the objective of this study was to assess the Asthma Impairment and Risk Questionnaire (AIRQ^®) construct validity relative to patient self-perception of asthma status and validated disease-specific patient-reported outcome (PRO) measures.

Patients and methods: Baseline data were analyzed from patients (aged ≥ 12 years) with asthma participating in a 12-month observational study assessing the ability of AIRQ to predict exacerbations. At entry, patients completed a sociodemographic questionnaire, AIRQ, 3 questions addressing self-perceived asthma status, Saint George's Respiratory Questionnaire (SGRQ), mini-Asthma Quality of Life Questionnaire (AQLQ), and Adult Asthma Adherence Questionnaire (AAAQ). Descriptive statistics were calculated for demographic and clinical characteristics. AIRQ construct validity was evaluated by assessing correlations between total AIRQ score and patient self-assessments, SGRQ, mini-AQLQ, and AAAQ scores. Comparisons of SGRQ, mini-AQLQ, and AAAQ total and component/domain scores by AIRQ control category were performed using general linear models and Scheffe's post hoc adjustments for pairwise comparisons.

Results: A total of 1112 patients were enrolled: 70% female, 78% White, mean (standard deviation) age 43.9 (19.5) years. There were highly significant correlations between AIRQ score and patient self-perception of overall control (r = 0.69; p < 0.001), total SGRQ (r = 0.74, p < 0.001), and mini-AQLQ (r = -0.78, p < 0.001) scores. As AIRQ control category worsened, so did total and domain SGRQ, mini-AQLQ, and AAAQ impediment-to-inhaled-corticosteroid-adherence scores (all pairwise comparisons p < 0.001).

Conclusion: Findings demonstrate the construct validity of AIRQ relative to patient self-perception of asthma status, disease-specific PRO measures, and treatment adherence barriers. AIRQ can be a useful instrument to raise awareness of the unrecognized impacts of asthma on patients' lives.

Keywords: construct validity; exacerbation; impact of asthma; patient-reported outcomes.

Grants and funding

This work was supported by AstraZeneca (Wilmington, DE, United States). The Asthma Impairment and Risk Questionnaire (AIRQ) was developed with support from the AstraZeneca PRECISION program. Employees of AstraZeneca (IG, JME, and HNG) satisfied all ICMJE requirements for authorship of this manuscript and were therefore involved in the study design; collection, analysis, and interpretation of data; writing of the manuscript; and the decision to submit the manuscript for publication.