Utility of brief questionnaires of health-related quality of life (Airways Questionnaire 20 and Clinical COPD Questionnaire) to predict exacerbations in patients with asthma and COPD

Abstract

BackgroundThere is some evidence that quality of life measured by long disease-specific questionnaires may predict exacerbations in asthma and COPD, however brief quality of life tools, such as the Airways Questionnaire 20 (AQ20) or the Clinical COPD Questionnaire (CCQ), have not yet been evaluated as predictors of hospital exacerbations.ObjectivesTo determine the ability of brief specific health-related quality of life (HRQoL) questionnaires (AQ20 and CCQ) to predict emergency department visits (ED) and hospitalizations in patients with asthma and COPD, and to compare them to longer disease-specific questionnaires, such as the St George´s Respiratory Questionnaire (SGRQ), the Chronic Respiratory Disease Questionnaire (CRQ) and the Asthma Quality of Life Questionnaire (AQLQ).MethodsWe conducted a two-year prospective cohort study of 208 adult patients (108 asthma, 100 COPD). Baseline sociodemographic, clinical, functional and psychological variables were assessed. All patients completed the AQ20 and the SGRQ. COPD patients also completed the CCQ and the CRQ, while asthmatic patients completed the AQLQ. We registered all exacerbations that required ED or hospitalizations in the follow-up period. Differences between groups (zero ED visits or hospitalizations versus ≥ 1 ED visits or hospitalizations) were tested with Pearson´s X2 or Fisher´s exact test for categorical variables, ANOVA for normally distributed continuous variables, and Mann–Whitney U test for non-normally distributed variables. Logistic regression analyses were performed to estimate the predictive ability of each HRQoL questionnaire.ResultsIn the first year of follow-up, the AQ20 scores predicted both ED visits (OR: 1.19; p = .004; AUC 0.723) and hospitalizations (OR: 1.21; p = .04; AUC 0.759) for asthma patients, and the CCQ emerged as independent predictor of ED visits in COPD patients (OR: 1.06; p = .036; AUC 0.651), after adjusting for sociodemographic, clinical, and psychological variables. Among the longer disease-specific questionnaires, only the AQLQ emerged as predictor of ED visits in asthma patients (OR: 0.9; p = .002; AUC 0.727). In the second year of follow-up, none of HRQoL questionnaires predicted exacerbations.ConclusionsAQ20 predicts exacerbations in asthma and CCQ predicts ED visits in COPD in the first year of follow-up. Their predictive ability is similar to or even higher than that of longer disease-specific questionnaires.

The influence of hospitalizations due to exacerbations or spontaneous pneumothoraxes on the quality of life, mental function and symptoms of depression and anxiety in patients with COPD or asthma

“…To determine the health-related quality of life (HRQoL), St. George's Respiratory Questionnaire (SGRQ) and the AQ20, a questionnaire that predicts the need for emergency intervention or hospitalization in patients with asthma and COPD, were used [5,6,[14][15][16][17]. The Mini-Mental State Examination (MMSE) was used to examine mental function [18].…”

“…Each category has a score range of 0 (best health) to 100 (worst health). This questionnaire has good reproducibility, is correlated with a range of established measures of disease activity, and responds to improvement and deterioration in the health of patients with chronic airflow limitations [6]. In this study, only the total score was analyzed.…”

“…The summary score ranges from 1 (best health) to 20 (worst health). The AQ20 demonstrates good reliability and validity [6].…”

“…in the case of pneumothorax). Some believe that the poor QoL in these patients is a result of chronic disease, but it has also been demonstrated that there is an additional negative impact on somatic disease [2,6]. This is because patients with a low QoL are less likely to cooperate with doctors, use their medication or exercise [2][3][4][5].…”

A simple home-based self-monitoring tool for early detection of hand-foot syndrome in cancer patients

“…For these reasons, to enhance early detection, we sought to develop a self-monitoring tool for patients to assess HFS symptoms at home. QOL measures have recently been proven useful for monitoring symptoms that are difficult for others to detect because they are more subjective and for screening for symptoms requiring treatment and care (17)(18)(19)(20)(21)(22). Developed by Sibaud et al (23), the HFS-14 is a disease-specific QOL scale for patients with HFS that differs from the CTCAE and is useful for self-monitoring symptoms because it was developed for patient response and includes items that facilitate improved assessment of at least grade 2 symptoms affecting daily life.…”