IMPLEMENTING THE ASTHMA IMPAIRMENT AND RISK QUESTIONNAIRE (AIRQ®) AND ASTHMA CHECKLIST INTO DIVERSE CLINICAL PRACTICES

Abstract

<h3>Introduction</h3> The Asthma Impairment and Risk Questionnaire (AIRQ®) is a 10 item, yes/no, impairment- and risk-based control assessment. Scores of 0-1 indicate well-controlled (WC), 2-4 not-well controlled (NWC), and 5-10 very poorly controlled (VPC) asthma. The Asthma Checklist is a decision support tool designed to facilitate implementation of Guideline and Expert Report recommendations into practice at point-of-care. <h3>Methods</h3> 840 patients with asthma aged ≥13 years completed AIRQ® at the start of a practice implementation study in primary care (n=6), specialty practice (n=6), and an educational asthma coaching program (n=1). Clinicians/educators reviewed AIRQ® responses with their patients in face-to-face or telehealth visits and indicated which Asthma Checklist items they planned to address. Items chosen were compared among AIRQ® control levels and practice types (Chi-square, p≤0.05). <h3>Results</h3> 70.5% were female; age 45.4(±18.4) years; AIRQ®: 42.3% WC, 31.5% NWC, 26.2% VPC. Adherence and appropriate therapy were assessed for the majority of patients, regardless of control (<b>TABLE</b>). Overall and individually for primary and specialty care, all other Asthma Checklist items were assessed more frequently with worsening control (p<0.01, for each). Aside from phenotyping, evaluating alternative diagnoses/hidden comorbidities, and considering advanced/add-on therapies, the educational coaching program assessed more Asthma Checklist items (p<0.01 for each) without regard for control level. <h3>Conclusion</h3> The asthma educational coaching program addressed more concepts from the Asthma Checklist; whereas primary care and specialty clinicians' assessments were more targeted to control level. Longitudinal follow-up is planned to determine the impact of implementing AIRQ® and Asthma Checklist into primary and specialty practices.