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

BACKGROUND: 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.

METHODS: 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.

RESULTS: Concurrent validity: In linear regressions, unmet patient needs were 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 (e.g. intra-class correlation coefficients for total score=0.78). The SDC (0.384) was slightly larger than MIC.

CONCLUSION: NEAT is a promising tool for assessing asthma treatment needs. This article is protected by copyright. All rights reserved.