ABSTRACT
BACKGROUND: The present study aimed to develop a short validated patient-completed questionnaire, the RhinAsthma Patient Perspective (RAPP), to assess the health-related quality of life (HRQoL) in patients with asthma and comorbid allergic rhinitis in clinical practice. METHODS: A provisional RAPP questionnaire was formed from candidate items identified through retrospective analysis of 333 RHINASTHMA questionnaires. This was then tested on 150 asthma patients with allergic rhinitis. RESULTS: Psychometric analyses identified eight items fitting a unidimensional model to form RAPP. Internal consistency (Cronbach's alpha coefficient > 0.8) and agreement with RHINASTHMA (r = -0.31, P = 0.0001) were excellent. Criterion, discriminant, and convergent validity were good. Reliability in 47 stable patients was very good (intra-class and concordance correlation coefficients were 0.90 and 0.89, respectively). Responsiveness in 103 patients with health improvement or deterioration was significantly associated with changes in Global Rating Scale (r = -0.4965, P < 0.01), Rhinitis Visual Analogue Scale (r = 0.5722, P < 0.01) and asthma control test (r = -0.6483, P < 0.01). Minimal clinical difference in the analyzed population was 2. CONCLUSION: RhinAsthma Patient Perspective is a simple eight-question questionnaire with good measurement properties and sensitivity to health changes, which will provide a valid, reliable and standardized HRQoL measurement in patients with asthma and comorbid allergic rhinitis in clinical practice.
Subject(s)
Asthma/psychology , Quality of Life , Rhinitis, Allergic, Perennial/psychology , Surveys and Questionnaires , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Psychometrics , Rhinitis, AllergicABSTRACT
The objective of the present study was to investigate the level of asthma control in real life and the relationship between Asthma Control Test (ACT) scores and sleep disturbances. Patients on control visits for bronchial asthma were asked to complete the ACT questionnaire and to answer 5 questions about their sleep quality (S5). It was found that asthma control was unsatisfactory in 44%. In all ACT classes the level of asthma control appeared to be inversely related to the presence of sleep disturbances: patients with good control reported less frequent and less severe sleep disturbances than uncontrolled subjects. However, a significant percentage of subjects (11-20%) with total control of asthma still had sleep disturbances that resulted in an impaired quality of life. Therefore in any asthma case with sleep disturbances a broader investigation is required whether that impairment is actually a result of asthma or some other co-morbidity. Thus it would be useful if patients who reported sleep disturbances despite good/total control of asthma and rhinitis were managed with a holistic clinical approach and underwent nocturnal polysomnographic monitoring.
