Skip to main content

Advertisement

SpringerLink
Log in

Validation of the AQLQ12+ among adolescents and adults with persistent asthma

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Background

To date, there is limited psychometric evidence on the Asthma Quality of Life Questionnaire (AQLQ12 +) among populations that include adolescents and adults.

Objective

To provide evidence of the psychometric properties of the AQLQ12+ as a measure of asthma-specific quality of life (QOL) in patients with persistent asthma treated with a combination of inhaled glucocorticoid and long-acting beta2-agonist, as well as explore the predictors of at least a minimally important AQLQ12+ improvement.

Methods

The psychometric properties of the AQLQ12+ were assessed through post hoc analysis of two large (n = 740 and 778) Phase III, randomized, double-blinded, placebo-controlled efficacy studies of mometasone furoate/formoterol fumarate (MF/F) combination compared with monotherapy in subjects with persistent asthma previously treated with either low-dose or medium-dose inhaled glucocorticoids.

Results

With 15% and 8% participation from 12- to 17-year olds, blinded trial data demonstrated excellent reproducibility (ICC range: 0.76–0.85) and moderate-to-strong construct validity with other measures of asthma health at baseline and over time for the AQLQ12 +. A greater percentage of the MF/F treatment group (44%) achieved an important change at 26 weeks on the AQLQ12+ compared with formoterol fumarate (F, 23%) and placebo (18%) treatment groups in the low-dose study (P < 0.001) and the medium-dose study (50% (MF/F) versus 34% (F) and 23% (placebo); P < 0.001). Pre-randomization nighttime awakenings and rescue medications use were significant predictors of AQLQ12+ improvement.

Conclusions

These findings provide strong support for the measurement properties of the AQLQ12+ among patients with persistent asthma and confidence in the AQLQ12+ improvements demonstrated by the MF/F treatment group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ACQ:

Asthma Control Questionnaire

AQLQ12+:

Asthma quality of life questionnaire with standardized activities (12 and older)

AQLQ(S):

Asthma quality of life questionnaire-standardized version

BID:

Twice a day

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

F:

Formoterol fumarate

FEV1 :

Forced expiratory volume in one second

HIV:

Human immunodeficiency virus

ICC:

Intraclass correlation coefficient

MDI:

Metered dose inhaler

MID:

Minimal important difference

MF:

Mometasone furoate

MF/F:

Mometasone furoate/formoterol fumarate

PEF:

Peak expiratory flow

QOL:

Quality of life

SAS:

Statistical analysis software

References

  1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention (updated 2008). Available at: http://www.ginasthma.org/Guidelineitem.asp??l1=2&l2=1&intId=60.

  2. Gergen, P. J., Arbes, S. J., Jr., Calatroni, A., Mitchell, H. E., & Zeldin, D. C. (2009). Total IgE levels and asthma prevalence in the US population: Results from the National Health and Nutrition examination survey 2005–2006. The Journal of allergy and clinical immunology, 124(3), 447–453.

    Article  PubMed  Google Scholar 

  3. Mannino, D. M., Homa, D. M., Akinbami, L. J., Moorman, J. E., Gwynn, C., & Redd, S. C. (2002). Surveillance for asthma–United States, 1980–1999. MMWR Surveill Summ, 51(1), 1–13.

    Google Scholar 

  4. Juniper, E. F., Svensson, K., Mork, A. C., & Stahl, E. (2005). Modification of the asthma quality of life questionnaire (standardised) for patients 12 years and older. Health Qual Life Outcomes, 3, 58.

    Article  PubMed  Google Scholar 

  5. Juniper, E. F., Buist, A. S., Cox, F. M., Ferrie, P. J., & King, D. R. (1999). Validation of a standardized version of the asthma quality of life questionnaire. Chest, 115(5), 1265–1270.

    Article  PubMed  CAS  Google Scholar 

  6. Mancuso, C. A., Rincon, M., McCulloch, C. E., & Charlson, M. E. (2001). Self-efficacy, depressive symptoms, and patients’ expectations predict outcomes in asthma. Medical Care, 39(12), 1326–1338.

    Article  PubMed  CAS  Google Scholar 

  7. Almada Lobo, F., & Almada-Lobo, B. (2008). Quality of life in asthmatic outpatients. Journal of Asthma, 45(1), 27–32.

    Article  PubMed  Google Scholar 

  8. Apter, A. J., Reisine, S. T., Affleck, G., Barrows, E., & ZuWallack, R. L. (1999). The influence of demographic and socioeconomic factors on health-related quality of life in asthma. The Journal of allergy and clinical immunology, 103(1 Pt 1), 72–78.

    Google Scholar 

  9. (July 2007). National heart, lung, and blood institute. Expert panel report 3: Guidelines for the diagnosis and management of asthma. Bethesda, MD, National Asthma Education and Prevention Program, National Heart, Lung and Blood Institute, National Institutes of Health.

  10. Crapo, R. O. (1989). Reference values for lung function tests. Respiratory CRE, 34, 626–637.

    Google Scholar 

  11. Polgar, G., & Promadhat, V. (1971). Pulmonary function testing in children: Technique and standards. Philadelphia, PA: W.B. Saunders.

    Google Scholar 

  12. Nathan, R. A., Nolte, H., & Pearlman, D. S. (2010). Twenty-six-week efficacy and safety study of mometasone furoate/formoterol 200/10 microg combination treatment in patients with persistent asthma previously receiving medium-dose inhaled corticosteroids. Allergy and Asthma Proceedings, 31(4), 269–279.

    Article  PubMed  CAS  Google Scholar 

  13. Juniper, E. F., O’Byrne, P. M., Guyatt, G. H., Ferrie, P. J., & King, D. R. (1999). Development and validation of a questionnaire to measure asthma control. European Respiratory Journal, 14(4), 902–907.

    Article  PubMed  CAS  Google Scholar 

  14. van den Nieuwenhof, L., Schermer, T., Eysink, P., Halet, E., van Weel, C., Bindels, P., et al. (2006). Can the asthma control questionnaire be used to differentiate between patients with controlled and uncontrolled asthma symptoms? A pilot study. Family Practice, 23(6), 674–681.

    Article  PubMed  Google Scholar 

  15. van den Nieuwenhof, L., Schermer, T., Heins, M., Grootens, J., Eysink, P., Bottema, B., et al. (2008). Tracing uncontrolled asthma in family practice using a mailed asthma control questionnaire. Annals of Family Medicine, 6(Suppl 1), S16–S22.

    Article  PubMed  Google Scholar 

  16. Juniper, E. F., Svensson, K., Mork, A. C., & Stahl, E. (2005). Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Respiratory Medicine, 99(5), 553–558.

    Article  PubMed  Google Scholar 

  17. Santanello, N. C., Barber, B. L., Reiss, T. F., Friedman, B. S., Juniper, E. F., & Zhang, J. (1997). Measurement characteristics of two asthma symptom diary scales for use in clinical trials. European Respiratory Journal, 10(3), 646–651.

    PubMed  CAS  Google Scholar 

  18. Hays, R., & Revicki, D. A. (2005). Reliability and validity (including responsiveness). In P. Fayers & R. Hays (Eds.), Assessing quality of life in clinical trials (pp. 25–39). New York: Oxford University Press.

    Google Scholar 

  19. Streiner, D. L., & Norman, G. R. (2003). Health measurement scales: A practical guide to their development and use. Oxford: Oxford University Press.

    Google Scholar 

  20. Fleiss, J. L. (1981). Statistical methods for rates and proportions. New York: Wiley.

    Google Scholar 

  21. Hinkle, D. E., Jurs, S. G., & Wiersma, W. (1988). Applied statistics for the behavioral sciences. Boston: Houghton Mifflin.

    Google Scholar 

  22. Juniper, E. F., Guyatt, G. H., Willan, A., & Griffith, L. E. (1994). Determining a minimal important change in a disease-specific quality of life questionnaire. Journal of Clinical Epidemiology, 47(1), 81–87.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Funding for this manuscript was provided by Schering-Plough Corporation, now a division of Merck and Co.

Author information

Authors and Affiliations

  1. United BioSource Corporation, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD, 20814, USA

    Kathleen W. Wyrwich & Andrea M. Ireland

  2. DataMed Solutions LLC, Hilliard, OH, USA

    Prakash Navaratnam

  3. Merck Research Laboratories, Kenilworth, NJ, USA

    Hendrik Nolte & Davis F. Gates Jr.

Authors
  1. Kathleen W. Wyrwich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea M. Ireland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Prakash Navaratnam
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hendrik Nolte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Davis F. Gates Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathleen W. Wyrwich.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wyrwich, K.W., Ireland, A.M., Navaratnam, P. et al. Validation of the AQLQ12+ among adolescents and adults with persistent asthma. Qual Life Res 20, 903–912 (2011). https://doi.org/10.1007/s11136-010-9821-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-010-9821-3

Keywords

Search

Navigation