An Update on Patient-Reported Outcomes in Asthma.

Chest

Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston TX.

Published: May 2024

AI Article Synopsis

  • Patient-reported outcomes (PROs) are crucial for understanding a patient's health and well-being, with patient-reported outcome measures (PROMs) offering a standardized way to assess aspects of health that can't be measured physically.
  • Asthma-specific PROMs have been developed to evaluate various disease characteristics, leading to inclusion in management guidelines, but real-world evidence on their effectiveness remains limited, especially for patients with poorly controlled asthma.
  • Two new PROMs, the Asthma Impairment and Risk Questionnaire and CompEx, aim to better assess asthma control and predict exacerbation risk, highlighting the need for more research on their practical use in clinical settings.

Article Abstract

Topic Importance: Patient-reported outcomes (PROs) are information provided by patients on their condition, function, well-being, or experience. Instruments to quantify PROs, called patient-reported outcome measures (PROMs), allow standardized assessment of a unique dimension of health that cannot be measured physically. Herein, we discuss how to appraise PROMs critically and provide an update on their use in asthma clinical practice and research.

Review Findings: Asthma-specific PROMs have been developed to measure a wide array of disease characteristics, including symptoms, medication use, exacerbations, and impairments to emotional and physical function. Some PROMs also include spirometry or expand questions to overlap with rhinitis symptoms. Use of PROMs to understand asthma control is included in management guidelines, yet real-world evidence of their effectiveness in improving asthma care remains limited. These instruments may be less accurate in characterizing patients with poorly controlled asthma and have modest correlation with exacerbation risk. Two new PROMs are highlighted, the Asthma Impairment and Risk Questionnaire as an instrument to assess asthma control that incorporates domains related to exacerbation risk and impairment, and the CompEx as a composite of daily diary reporting combined with exacerbation events as an early efficacy signal for interventional trials.

Summary: PROMs are fundamental to asthma assessment. Novel instruments may improve the detection of patients at risk for poor outcomes and shorten the drug discovery pipeline. However, urgent research is needed to understand their practical utility in clinical settings.

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Source
http://dx.doi.org/10.1016/j.chest.2024.02.010DOI Listing

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