Abstract
ntroduction There is currently no literature supporting the validity of patient recall of exacerbation events. Clinical practice and enrichment of exacerbation prone patients into clinical trials for asthma often relies on patient report to quantify annual oral corticosteroid (OCS) requiring exacerbation events.
NICE criteria to access biological therapies necessitates patients require either daily OCS or at least three or four acute OCS courses per year for Reslizumab and Mepolizumab respectively. Our objective was to assess the validity of patient recall of exacerbation events in a refractory asthma subgroup.
Methods All patients attending a tertiary-care asthma service over a 2 month period were given a questionnaire asking them to recall acute asthma events in the last 12 months, including medication received and acute care attendance. Validated was achieved by contacting GP practices for prescription records, review of ED charts and using a national Electronic Health Care Record (ECR).
Results 139 questionnaires were received. 52 patients reported they were not on maintenance steroids, 1 did not answer the questionnaire and 13 incorrectly reported they were in receipt of maintenance OCS.
Results for those not on maintenance OCS were analysed. 12 (23%) gave a range when reporting acute OCS courses taken in the last 12 months. Mean number of acute OCS courses/year was 2.9, mean difference between reported and confirmed courses −0.4 (CI −0.96 to 0.14, limits of agreement 3.37 to −4.19).
Using cross-tabulation to assess accuracy of reporting ≥4 OCS courses/year, 8.2% (4) incorrectly reported <4 OCS courses, under-reporting by an average of 3.5 courses (range 2–5). 10.2% (5) falsely reported ≥4 OCS courses, over-reporting by an average of 2.2 courses (range 1–3).
Assessing accuracy of report ≥3 OCS courses/year, 10.2% (5) incorrectly reported <3 OCS courses, under-reporting by between 1–4 courses (mean 2.2). 12.2% (6) incorrectly reported ≥3 OCS courses, over-reporting by between 1OC–3OCS courses (mean of 2).
Conclusion When using self-report to assess eligibility for biological therapies, 18.4% of patients would receive incorrect treatment outcomes for Mepolizumab and 22.4% for Reslizumab. If this were the case in other centres prescribing biologic therapy, an important number of patients would either receive or miss treatment inappropriately
NICE criteria to access biological therapies necessitates patients require either daily OCS or at least three or four acute OCS courses per year for Reslizumab and Mepolizumab respectively. Our objective was to assess the validity of patient recall of exacerbation events in a refractory asthma subgroup.
Methods All patients attending a tertiary-care asthma service over a 2 month period were given a questionnaire asking them to recall acute asthma events in the last 12 months, including medication received and acute care attendance. Validated was achieved by contacting GP practices for prescription records, review of ED charts and using a national Electronic Health Care Record (ECR).
Results 139 questionnaires were received. 52 patients reported they were not on maintenance steroids, 1 did not answer the questionnaire and 13 incorrectly reported they were in receipt of maintenance OCS.
Results for those not on maintenance OCS were analysed. 12 (23%) gave a range when reporting acute OCS courses taken in the last 12 months. Mean number of acute OCS courses/year was 2.9, mean difference between reported and confirmed courses −0.4 (CI −0.96 to 0.14, limits of agreement 3.37 to −4.19).
Using cross-tabulation to assess accuracy of reporting ≥4 OCS courses/year, 8.2% (4) incorrectly reported <4 OCS courses, under-reporting by an average of 3.5 courses (range 2–5). 10.2% (5) falsely reported ≥4 OCS courses, over-reporting by an average of 2.2 courses (range 1–3).
Assessing accuracy of report ≥3 OCS courses/year, 10.2% (5) incorrectly reported <3 OCS courses, under-reporting by between 1–4 courses (mean 2.2). 12.2% (6) incorrectly reported ≥3 OCS courses, over-reporting by between 1OC–3OCS courses (mean of 2).
Conclusion When using self-report to assess eligibility for biological therapies, 18.4% of patients would receive incorrect treatment outcomes for Mepolizumab and 22.4% for Reslizumab. If this were the case in other centres prescribing biologic therapy, an important number of patients would either receive or miss treatment inappropriately
| Original language | English |
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| Publication status | Published - 2018 |
| Event | British Thoracic society - London Duration: 06 Dec 2018 → 09 Dec 2018 |
Conference
| Conference | British Thoracic society |
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| Abbreviated title | BTS |
| Period | 06/12/2018 → 09/12/2018 |