Validated questionnaires heighten detection of difficult asthma comorbidities

Area of Science:

• Pulmonology
• Allergy and Immunology
• Psychiatry

Background:

• Difficult asthma is often influenced by extra-pulmonary comorbidities, complicating diagnosis.
• Clinical assessment alone may fail to identify these contributing conditions.
• Systematic evaluation is crucial for effective difficult asthma management.

Purpose of the Study:

• To identify validated screening questionnaires for extra-pulmonary comorbidities in difficult asthma.
• To evaluate the performance of these questionnaires in a clinical setting.
• To enhance the diagnostic yield of difficult asthma evaluations.

Main Methods:

• A systematic literature search of MEDLINE was conducted to find relevant screening tools.
• Questionnaires were selected based on ease of use, validated cut-off scores, and evidence of validation.
• 86 patients with difficult asthma completed questionnaires prior to clinical consultation.

Main Results:

• Six key comorbidities and their screening questionnaires were identified: sinonasal disease, vocal cord dysfunction, dysfunctional breathing, obstructive sleep apnea, anxiety/depression, and gastro-oesophageal reflux disease.
• Integrating questionnaires with clinical assessment significantly improved the detection of all six comorbidities.
• Questionnaire administration averaged approximately 40 minutes.

Conclusions:

• Validated screening questionnaires enhance the detection of comorbidities in difficult asthma.
• Pre-consultation questionnaire data streamline systematic patient assessment.
• Addressing comorbidities proactively can prevent unnecessary treatment escalation.