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

Area of Science:

• Respiratory Medicine
• Quality of Life Research
• Clinical Assessment Tools

Background:

• The RhinAsthma Patient Perspective (RAPP) is the sole validated instrument for assessing health-related quality of life (HRQoL) in patients with co-existing asthma and rhinitis.
• Understanding the HRQoL burden across different countries and patient subgroups is crucial for effective disease management.

Purpose of the Study:

• To compare the HRQoL burden associated with asthma and rhinitis across various countries.
• To evaluate the utility of the RAPP tool as a supplementary measure in managing patients with asthma and rhinitis.
• To identify optimal RAPP score cutoffs for detecting uncontrolled allergic rhinitis (AR) and asthma.

Main Methods:

• A post hoc analysis of the RAPP International Study data was conducted.
• Patients were categorized into four groups based on the control status of their rhinitis and asthma: controlled asthma/controlled rhinitis (CA/CR), uncontrolled rhinitis/controlled asthma (CA/UR), controlled rhinitis/uncontrolled asthma (UA/CR), and uncontrolled rhinitis/uncontrolled asthma (UA/UR).
• Statistical analysis compared RAPP scores among countries and disease control groups, and determined the best cutoffs for detecting uncontrolled AR and asthma.

Main Results:

• Significant variations in mean RAPP scores were observed among participating countries, with scores ranging from 15.7 in Spain to 18.7 in the Philippines.
• Patients with uncontrolled rhinitis and/or asthma (UR/CA, CR/UA, UR/UA) reported significantly higher HRQoL burdens, indicated by elevated RAPP scores, compared to those with both conditions controlled.
• Optimal RAPP score cutoffs were identified for detecting uncontrolled AR (≥15), uncontrolled asthma (≥16), and both uncontrolled AR and asthma (≥18), demonstrating good sensitivity and specificity.

Conclusions:

• The RAPP tool provides valuable insights into the individual HRQoL burden experienced by patients with asthma and rhinitis in real-world clinical settings.
• RAPP scores can quantify the contribution of uncontrolled allergic rhinitis and asthma to the overall disease burden.
• The findings support the use of RAPP as a clinical support tool for disease management, enabling better identification and treatment of uncontrolled conditions.