Evaluating quality of life in patients with asthma and rhinitis: English adaptation of the rhinasthma questionnaire

Abstract

Background: Separate health-related quality of life (HRQL) instruments exist for asthma and rhinitis. The Rhinasthma questionnaire, originally developed in Italian, is a unique measure designed for use where both conditions coexist.

Objective: We sought to assess the performance and validity of a new adaptation of the Rhinasthma questionnaire for use in English-speaking populations.

Methods: We analyzed cross-sectional data from an ongoing study of adults with asthma and rhinitis (n = 450), asthma alone (n = 75), or rhinitis alone (n = 20). Subjects were administered an English translation of the original 30-item Rhinasthma questionnaire. Health status measures simultaneously assessed include the Short Form (SF)-12, EuroQol (EQ)-5D, and Marks Asthma Quality-of-Life.

Results: Variable cluster analysis of the original 30-item instrument identified 5 discrete item clusters corresponding to the following domains: nasal (5 items), eye (4 items), respiratory (5 items), activity restriction (9 items), and treatment burden (5 items). Two other items were removed because of poor item-cluster correlations. Subjects with concomitant asthma and rhinitis had greater HRQL impairment, as measured by the Rhinasthma, than subjects with either asthma or rhinitis alone. The Rhinasthma correlated significantly (P < .05) with the SF-12, EQ-5D, and Marks Asthma Quality-of-Life in the anticipated direction consistent with the underlying constructs. In multiple logistic regression, poorer Rhinasthma HRQL was associated with significantly (P < .05) increased odds of both asthma- and rhinitis-related disability even after taking into account physical health status as measured by the SF-12.

Conclusion: The 28-item English adaptation of Rhinasthma performs well in assessing HRQL in patients with asthma, rhinitis, or both conditions combined.

Conflict of interest statement

Conflicts of interest: None of the authors have any conflicts of interests to report. This study and its authors are funded by the NIH. None of the authors listed are government employees.

Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Flow of subject recruitment, retention, and integration the Asthma Rhinitis Cohort and Severe Asthma Cohort. Of the 549 subjects in the Merged Asthma Cohort, 189 (35%) were originally recruited from pulmonary and allergy specialty practices, 38 (7%) from family medicine practices, 88 (16%) by random digit dial, and 234 (42%) based on prior hospitalization for asthma.

Figure 2

Dendrogram (or “Tree” diagram) illustrating the iterative splitting technique utilized by variable cluster analysis. Successive splits are shown from left to right. The distance of each vertical branch from the origin at the left represents the proportion of variance explained for each cluster solution. The total variance explained by the 5-cluster solution was 63.3%.