Can a Patient’s Asthma Impairment and Risk Questionnaire Score Predict HRQoL?

The following article features coverage from the American College of Allergy, Asthma & Immunology 2021 Annual Scientific Meeting, being held virtually from November 4 to 8, 2021. Click here to read more of MPR‘s conference coverage from the ACAAI 2021 Annual Scientific Meeting.

The baseline Asthma Impairment and Risk Questionnaire (AIRQ) score may predict 12-month health-related quality of life (HRQoL) in patients with asthma, according to authors of a study presented at the 2021 American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, held in New Orleans from November 4 to 8.

The 10-item asthma control tool, AIRQ, has been validated in patients 12 years of age and older (scores 0 to 1 indicate well-controlled disease; scores 2 to 4 indicated not well controlled asthma; and scores 5 to 10 indicate very poorly controlled asthma). To evaluate the ability of AIRQ to predict HRQoL in patients participating in a 12-month longitudinal validation study, the investigators obtained baseline AIRQ scores, demographic and clinical characteristics, and responses to the St. George’s Respiratory Questionnaire (SGRQ) at baseline, 6 months, and 12 months.

A statistical model was used to assess the change in the SGRQ total score at 12 months. It included numerous covariates that were previously shown to be significantly associated with patient-reported exacerbations during the study. These were baseline AIRQ control level, SGRQ score, age, sex, education, body mass index (BMI), sleep apnea, fractional exhaled nitric oxide, Global Initiative for Asthma (GINA)-level treatment class, 2 or more prior-year oral corticosteroid courses, timing of exacerbations, and changes in treatment and AIRQ score over the study period.

A total of 1112 patients with a mean age of 43.9 (SD, 19.5) years were evaluated About three-fourths of the patients (71.1%) were female. According to AIRQ scores, asthma was well controlled in 35%, not well controlled in 38%, and very poorly controlled in 27% of patients.  

The change in SGRQ total score at 12 months indicated significant worsening (about 18.8 points higher; 95% CI, 15.47-22.10) for patients with very poorly controlled asthma and with not well-controlled asthma at baseline (about 7.7 points higher; 95% CI, 5.52-9.85) relative to those with well-controlled asthma. For each point increase in AIRQ score from baseline to 12 months, the SGRQ total score increased by 3.7 points (95% CI, 3.41-3.95).

Other covariates associated with worse HRQoL included male sex, comorbid sleep apnea, number of exacerbations over the 12-month follow up period, and BMI; covariates associated with better HRQoL included higher levels of education and baseline SGRQ total score.

The investigators concluded, “Asthma control as measured by AIRQ may be predictive of HRQoL over 12 months.”

Reference

Murphy K, Chipps B, Wise R, et al. Asthma impairment and risk questionnaire (AIRQ) at baseline predicts 12-month health-related quality of life (HRQoL). Presented at: American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting; November 4-8, 2021; New Orleans, LA. Abstract P060.

This article originally appeared on Pulmonology Advisor