IMPLEMENTATION OF THE US ASTHMA IMPAIRMENT AND RISK QUESTIONNAIRE (AIRQ) AND AIRCOMPASS TOOLS IN CLINICAL PRACTICE

Abstract

SESSION TITLE: Getting It Right: Personalized Strategies for Better Asthma Control SESSION TYPE: Original Investigations PRESENTED ON: 10/20/2019 2:15 PM - 3:15 PM PURPOSE: The Asthma Impairment and Risk Questionnaire (AIRQ™) and the Evaluation and Management Navigator (AIRCOMPASS™) are interactive tools developed by the US PRECISION National Working Group in collaboration with AstraZeneca. Both tools aim to identify patients at risk for adverse outcomes from uncontrolled asthma (UA) and guide clinicians in assessing patients and selecting treatments. The primary objective was to evaluate the feasibility, usability, and potential benefits of integrating these tools into clinical practice. METHODS: This cross-sectional feasibility study was conducted at 6 clinical sites (2 primary care, 2 pulmonology, 2 allergy/immunology) across the US. The AIRQ™ and AIRCOMPASS™ Web-based platform was integrated into these practices. On recruiting days, all patients ≥12 years with an asthma diagnosis presenting to participating clinics were asked to complete a paper or electronic version of the AIRQ™, consisting of 10 equally weighted yes/no questions assessing the impairment and risk domains for asthma control. A higher number of yes responses indicates worse control. Data on the clinicians' use of AIRCOMPASS™ components were captured and results summarized using descriptive statistics. Post-study qualitative interviews were conducted with clinicians and key clinical staff at each site to evaluate AIRQ™ feasibility and usability. RESULTS: Of 315 evaluable patients, 278 completed the AIRQ™. The majority of evaluable patients (94%) were ≥18 years of age. The mean risk score was 3.9 of 10 (SD: 2.5); 19% of patients were categorized as low-risk (0-1), 41% as medium-risk (2-4), and 40% as high-risk (5-10 yes responses). The mean AIRCOMPASS™ session was 7.31 minutes with an average of 6.4 page views. Qualitative interviews with 11 clinicians and 6 site coordinators indicate AIRQ™ was generally easy to use and provided valuable information for patients at higher risk for adverse health outcomes from UA. Importantly, implementation did not adversely affect the clinic flow. Physicians described the AIRCOMPASS™ as a useful resource to guide physician-patient conversations and also provided feedback for improvements. CONCLUSIONS: The AIRQ™ provides physicians with valuable insights on patients' asthma control and is able to detect a significant portion of patients with uncontrolled or poorly controlled asthma. Physician feedback on AIRCOMPASS™ indicated it facilitated patient-provider treatment plan discussions. CLINICAL IMPLICATIONS: Published literature suggests up to 50% prevalence of UA; in our study 81% were at medium or high risk for UA. Integrating the AIRQ™ and AIRCOMPASS™ into routine clinical practice appears to be feasible and holds promise in improving overall care of asthma. A full validation is in progress. DISCLOSURES: Advisory Committee Member relationship with AstraZeneca LLP Please note: $20001 - $100000 Added 03/13/2019 by David Beuther, source=Web Response, value=Consulting fee Advisory Committee Member relationship with GlaxoSmithKline Please note: $5001 - $20000 Added 03/13/2019 by David Beuther, source=Web Response, value=Consulting fee Employee relationship with Astrazeneca Please note: >$100000 Added 03/13/2019 by James Eudicone, source=Web Response, value=Salary Employee relationship with AstraZeneca Please note: >$100000 Added 03/14/2019 by Hitesh Gandhi, source=Web Response, value=Salary My spouse/partner as a Employee relationship with Pfizer Please note: >$100000 Added 03/14/2019 by Hitesh Gandhi, source=Web Response, value=Salary Employee relationship with AstraZeneca Please note: >$100000 Added 03/13/2019 by Ileen Gilbert, source=Web Response, value=Salary My spouse/partner as a Consultant relationship with Abbott Please note: $20001 - $100000 Added 03/13/2019 by Ileen Gilbert, source=Web Response, value=Consulting fee Consultant relationship with AstraZeneca Please note: >$100000 Added 03/15/2019 by Gale Harding, source=Web Response, value=Consulting fee No relevant relationships by Melissa Ross, source=Web Response Consultant relationship with Astra Zeneca Please note: $5001 - $20000 Added 03/19/2019 by Siddhartha Singh, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with Astra Zeneca Please note: $5001 - $20000 Added 11/24/2018 by Shyamsunder Subramanian, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with TEVA Please note: $5001 - $20000 Added 11/24/2018 by Shyamsunder Subramanian, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with Genentech Please note: $5001 - $20000 Added 11/24/2018 by Shyamsunder Subramanian, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with Boehringer Ingelheim Please note: $5001 - $20000 Added 11/24/2018 by Shyamsunder Subramanian, source=Web Response, value=Consulting fee