Measuring Health-Related Quality of Life in Adults During an Acute Asthma Exacerbation. Part 5
October 23rd, 2020 by admin | Posted in Uncategorized
The observed high a values of 0.90 for the overall score, and 0.82 and 0.86, respectively, for the symptom and emotional function domains provide evidence that patients were consistent in their responses to the questions.
Although the Acute AQLQ was developed for use in clinical trials, is there a place for it in a busy emergency department where the majority of patients recover in a few hours? If patients’ overall well-being and recovery are helped by the identification of the causes and degree of distress, the few minutes required to obtain this information may be considered worthwhile. Although the original AQLQ was designed for clinical trials, its use in clinical practice is growing. It may be that as clinicians use the Acute AQLQ in trials, they also will find it to be a quick and easy way to identify the needs of their patients.
This study has highlighted the fact that, although it is obviously very important to focus treatment on the airways during an acute severe exacerbation of asthma, clinicians also should be aware of how distressing the experience is for patients not only from the perspective of the symptoms, but also from their emotional experiences. The validation of the Acute AQLQ means that not only can patients’ experiences be measured during clinical trials, but clinicians can use the questionnaire to identify the degree and causes of their patients’ distress.
Study objectives: To identify which tests would be useful in selecting patients for a specific inhalation challenge with bovine dander allergens (bSIC).
Design: A prospective study.
Setting: A university hospital.
Patients: Thirty-seven dairy farmers with a clinical suspicion of occupational asthma due to bovine allergens.
Interventions: Each patient (n = 27) underwent histamine challenge, mannitol challenge, exhaled nitric oxide (NO) measurement, bovine-specific serum IgE measurement, and skin-prick test (SPT) with bovine allergens prior to undergoing a bSIC.
Results: Eleven patients responded to the inhalation challenge with bovine allergens. The sensitivity and specificity of the tests, based on this response, were 82% and 65%, respectively, for the histamine challenge; 20% and 94%, respectively, for the mannitol challenge; 27% and 77%, respectively, for the NO measurement; 82% and 100%, respectively, for the bovine-specific serum IgE measurement; and 100% and 50%, respectively, for the SPT. Multiple regression analysis revealed that only IgE-mediated sensitivity to bovine allergens, but neither bronchial hyperreactivity nor exhaled NO concentration, contributed significantly to the response.