A1430 - Evaluating Performance of the Asthma Impairment and Risk Questionnaire (AIRQ™) in Primary and Specialty Care
Author Block: W. McCann¹, J. Reibman², B. Chipps³, R. S. Zeiger⁴, D. A. Beuther⁵, R. A. Wise⁶, I. Gilbert⁷, J. M. Eudicone⁷, H. Gandhi⁷, M. Ross⁸, K. S. Coyne⁸, K. R. Murphy⁹, M. George¹⁰; ¹Allergy Partners, Asheville, NC, United States, ²New York University School of Medicine, New York, NY, United States, ³Capital Allergy & Respiratory Disease Center, Sacramento, CA, United States, ⁴Departments of Allergy and Research and Evaluation, Kaiser Permanente Southern California, San Diego and Pasadena, CA, United States, ⁵National Jewish Health, Denver, CO, United States, ⁶Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁷AstraZeneca, Wilmington, DE, United States, ⁸Evidera, Bethesda, MD, United States, ⁹Boys Town National Research Hospital, Boys Town, NE, United States, ¹⁰Columbia University School of Nursing, New York, NY, United States.
Rationale: The Asthma Impairment and Risk Questionnaire (AIRQ™) is a 10-item, equally-weighted, yes/no, composite control tool. The AIRQ™ was validated in a cross-sectional study of 442 patients with asthma aged ≥12 years recruited from specialty practices. The combination of selected AIRQ™ questions and score range (Well-controlled: 0-1, Not Well-controlled: 2-4, and Very Poorly Controlled: 5-10 yes responses) demonstrated high sensitivity and specificity to differentiate patients on either end of the control spectrum. The current study assessed construct validity of the AIRQ™ in primary and specialty care patients recruited from web-based panels by evaluating systemic corticosteroid and rescue therapy use as measures of asthma control. Methods: Participants aged ≥18 years self-reporting asthma and use of therapies across all Global Initiative for Asthma (GINA)-step severities were included. Sociodemographic and medical history forms, the Asthma Control Test (ACT™), and AIRQ™ were completed electronically. To determine AIRQ™ construct validity, ACT™ score, prior-year self-reported systemic corticosteroids for exacerbations, and rescue inhaler/nebulizer use were analyzed within provider groups relative to AIRQ™ control level (general linear models with Scheffe’s post hoc adjustment for pairwise comparisons). Results: 1153 patients (538 primary and 615 specialty care) were included: mean (SD) age 49 (15) years; 60% female; 68% White, 15% African American, 15% Hispanic/Latino; 33% GINA 3-5; and 43% with less than college degrees. Among the panel primary and specialty care patients, the AIRQ™ identified 48.7% and 25.4% as well-controlled, 33.5% and 32.8% as not well-controlled, and 17.8% and 41.8% as very poorly controlled, respectively. Control differences were supported by more primary care patients having well-controlled ACT™ scores (60.8% vs 32.4%) and fewer having ≥2 courses of oral corticosteroids (21.0% vs 50.7%) or steroid injections (7.6% vs 35.3%) for asthma exacerbations or rescue inhaler use (26.2% vs 44.2%) or nebulizer treatments (8.0% vs 26.8%) ≥3 times/week (p<0.0001, for each). Within provider groups, the proportion of patients with each of these indices of morbidity increased with worsening AIRQ™ control level (p<0.0001, for each) (Table). Conclusion: These data demonstrate the construct validity of the AIRQ™ among patients in primary and specialty care, as differences in AIRQ™ control levels were associated with differential proportions of patients reporting use of systemic corticosteroids for exacerbations and rescue therapy for uncontrolled symptoms. In addition to being a robust composite control tool, AIRQ™ can increase awareness for all providers as to their patients’ burden of disease. Funding: AstraZeneca