The Patient Needs in Asthma Treatment (NEAT) questionnaire: Further evidence on its psychometric properties.

Abstract

Building on previous psychometric work, we sought to assess the Patient Needs in Asthma Treatment (NEAT) questionnaire's validity, responsiveness to change, and the minimal important change (MIC) over a 3-year period (Study 1) and its reliability and the smallest detectable change (SDC) in a test-retest study (Study 2) among patients self-reporting physician-diagnosed asthma. In Study 1, a total of 207 patients completed a survey which included the NEAT, the Asthma Control Test (ACT), the Asthma Quality of Life Questionnaire-Sydney (AQLQ-S), and a question on treatment satisfaction in 2014 and 2017. In Study 2, a total of 78 patients completed NEAT twice on average four weeks apart in 2018. Concurrent validity: In linear regressions, unmet patient needs were cross-sectionally associated with poorer asthma control (β=-0.21; P=0.01), asthma-related quality of life (QoL) (β=0.31; P<0.01), and treatment satisfaction (β=-0.59; P<0.01). Predictive Validity: Higher unmet needs at baseline predicted worse treatment satisfaction at follow-up (β=-0.28; P<0.01), but neither asthma control nor asthma-related QoL. Responsiveness to change was demonstrated by linear regressions of changes in the total NEAT score and changes in AQLQ-S (β=0.21; P<0.01) and treatment satisfaction (β=-0.36; P<0.01). MIC: Patients whose NEAT score increased between baseline and follow-up by the identified MIC (0.301) reported lower treatment satisfaction at follow-up (β=-0.17; P=0.01). Test-retest reliability was demonstrated by correlations between NEAT baseline and follow-up scores (eg, intra-class correlation coefficients for total score=0.78). The SDC (0.384) was slightly larger than MIC. NEAT is a promising tool for assessing asthma treatment needs.