An Update on Patient-Reported Outcomes in Asthma.

Wu TD, Diamant Z, Hanania NA. An Update on Patient-Reported Outcomes in Asthma. Chest. 2024 Feb 14; DOI: 10.1016/j.chest.2024.02.010.

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 which cannot be physically measured. Here, we discuss how to critically appraise PROMs 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 is still 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 (AIRQ) as an instrument to assess asthma control which incorporates domains related to exacerbation risk and functional 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.