[Utilization and clinical validation of the Spanish version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Diary for Caregivers of Asthmatic Children (DCA). VALAIR study]

E Alonso Lebrero
Allergologia et Immunopathologia 2000, 28 (3): 175-83

UNLABELLED: Asthma is one of the most frequent chronic illnesses in paediatric age children. In the last reviews carried out by the group of experts (EPR II) in 1997, a chapter was included on education for the groups who are involved with looking after patients with asthma, and proposes the inclusion of questions focused on the valuation of results from the patients point of view, symptomatic improvement, concerns, quality of life and the objectives of the treatment. Over the last few years questionnaires have been designed that deal with the quality of life of asthma sufferers, that describe states of health and they also allow one to detect and quantify changes in the state of health. It has been demonstrated that the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Thermometer of General Health (Analogical Visual Scale AVS) can be used in clinical practise and in clinical tests to evaluate paediatric patients who have sufficient capacity to read and understand. In younger children the Diary of the Asthmatic Child Carer can be used (DAC). In the Valair Study the general objective is considered to be the nalysis of the use and validity, in Spain, of the PAQLQ and the DAC during regular clinical practise situations and a series of specific objectives related to the above.

MATERIAL AND METHODS: this type of study is observational and prospective. 1,012 patients between 6 and 14 years old were included, who were diagnosed as suffering from mild to moderate persistent asthma, according to the criteria established by the Global Initiative for Asthma. The children between 6 and 11 years old carried out a reading and comprehension test prior to their inclusion in the study. All the carers (father, mother or the person who is legally responsible who has lived with the child for the last three years) were taught how to fill in the DAC. The patients were divided into two groups A and B according to the clinical stability at the time they were included in the study. For the patients in group A (a group that is sensitive to change), the doctor considered it necessary, due to the fact that the asthma had been badly controlled, to add to the preliminary treatment, Montelukast (Singulair), a chewable 5 mg tablet and they changed or maintained the remaining medication according to the clinical criteria. The patients were checked 2 to 3 months after the initial visit. The patients in group B, reliability test-retest group, included patients who were clinically stable during the last month. This group was checked 2 to 4 weeks later.

RESULTS: different aspects were approached: a description of the clinical characteristics of the patients by study groups and the seriousness of the asthma. A description of the state of health of the patients and this was agreed among the observers. A description of the changes observed by the patients during the follow up period of the study and registered by the Doctor. An evaluation of the patients capacity to manage the questionnaires themselves. An evaluation of the measurement properties of the PAQLQ. An evaluation of the measurement properties of the DAC. An evaluation of the measurement properties of the EuroQol-5D.

CONCLUSIONS: the PAQLQ and the DCA have proven to be valid instruments to measure the quality of life of the children who suffer from asthma in Spain. The values of the PAQLQ reach a high degree of correlation with the seriousness of the asthma and the exerbations over the last year, which indicates a good relation between the perception that the child has of this own quality of life and the seriousness of the asthma. Young children are capable of correctly filling in the quality of life questionnaires and it doesn't take them too much time. (ABSTRACT TRUNCATED)

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