Rhinitis and Asthma Patient Perspective (RAPP): Clinical Utility and Predictive Value.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
03 2022
Historique:
received: 11 07 2021
revised: 06 10 2021
accepted: 07 10 2021
pubmed: 26 10 2021
medline: 21 4 2022
entrez: 25 10 2021
Statut: ppublish

Résumé

RhinAsthma Patient Perspective (RAPP) is the only validated tool for assessing of health-related quality of life (HRQoL) related to asthma and rhinitis in individual patients. To compare the HRQoL burden among countries and explore the usefulness of RAPP as a complementary measure in disease management. In this post hoc analysis of the RAPP International Study, the enrolled population was clustered into patients with controlled rhinitis and controlled asthma (CA/CR), uncontrolled rhinitis and controlled asthma (CA/UR), controlled rhinitis and uncontrolled asthma (UA/CR), and uncontrolled rhinitis and uncontrolled asthma (UA/UR). We recruited 575 adult patients. Significant differences among countries were observed in the mean RAPP score (from 15.7 in Spain to 18.7 in the Philippines) although the percentage of subjects with an optimal HRQoL (RAPP <15) was not significantly different. Compared with patients with AR and asthma disease control, those with UR/CA, CR/UA, and UR/UA had significantly higher RAPP scores (4.7, 5, and 9.8, respectively). The best cutoffs for detecting uncontrolled diseases were RAPP of 15 or greater (SE = 75%; specificity = 69%; and area under the receiver operating characteristic curve [AUC] = 0.78) for AR; RAPP of 16 or greater (SE = 78%; specificity = 76%; and AUC = 0.83) for asthma; and RAPP of 18 or greater (SE = 86%; specificity = 87%; and AUC = 0.92) for both AR and asthma. These findings provide a better understanding of the individual burden of HRQoL related to asthma and rhinitis in daily practice. In addition, the RAPP estimates how much of the risk for uncontrolled disease depends on uncontrolled AR and asthma, allowing its use as a clinical support tool in clinical management.

Sections du résumé

BACKGROUND
RhinAsthma Patient Perspective (RAPP) is the only validated tool for assessing of health-related quality of life (HRQoL) related to asthma and rhinitis in individual patients.
OBJECTIVE
To compare the HRQoL burden among countries and explore the usefulness of RAPP as a complementary measure in disease management.
METHODS
In this post hoc analysis of the RAPP International Study, the enrolled population was clustered into patients with controlled rhinitis and controlled asthma (CA/CR), uncontrolled rhinitis and controlled asthma (CA/UR), controlled rhinitis and uncontrolled asthma (UA/CR), and uncontrolled rhinitis and uncontrolled asthma (UA/UR).
RESULTS
We recruited 575 adult patients. Significant differences among countries were observed in the mean RAPP score (from 15.7 in Spain to 18.7 in the Philippines) although the percentage of subjects with an optimal HRQoL (RAPP <15) was not significantly different. Compared with patients with AR and asthma disease control, those with UR/CA, CR/UA, and UR/UA had significantly higher RAPP scores (4.7, 5, and 9.8, respectively). The best cutoffs for detecting uncontrolled diseases were RAPP of 15 or greater (SE = 75%; specificity = 69%; and area under the receiver operating characteristic curve [AUC] = 0.78) for AR; RAPP of 16 or greater (SE = 78%; specificity = 76%; and AUC = 0.83) for asthma; and RAPP of 18 or greater (SE = 86%; specificity = 87%; and AUC = 0.92) for both AR and asthma.
CONCLUSIONS
These findings provide a better understanding of the individual burden of HRQoL related to asthma and rhinitis in daily practice. In addition, the RAPP estimates how much of the risk for uncontrolled disease depends on uncontrolled AR and asthma, allowing its use as a clinical support tool in clinical management.

Identifiants

pubmed: 34695596
pii: S2213-2198(21)01144-2
doi: 10.1016/j.jaip.2021.10.025
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

846-852.e1

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Ilaria Baiardini (I)

Respiratory Unit for Continuity of Care, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy; Personalized Medicine Asthma, and Allergy Clinic, Istituti di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy. Electronic address: ilaria.baiardini@libero.it.

Salvatore Fasola (S)

Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy.

Stefania La Grutta (S)

Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy.

Elisa Trucco (E)

Respiratory Unit for Continuity of Care, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy.

Giorgio Walter Canonica (GW)

Personalized Medicine Asthma, and Allergy Clinic, Istituti di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Fulvio Braido (F)

Respiratory Unit for Continuity of Care, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy.

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