The Asthma Impairment and Risk Questionnaire (AIRQ) Control Level Predicts Future Risk of Asthma Exacerbations

BACKGROUND: The Asthma Impairment and Risk Questionnaire (AIRQ) is a 10-item, equally weighted, yes/no con-trol tool validated in patients with asthma aged 12 years and older.OBJECTIVE: To evaluate AIRQ's ability to predict patient -reported exacerbations over 12 months.METHODS: Patients completed a baseline AIRQ during an in -person enrollment visit and reported exacerbations (ie, asthma -related courses of oral corticosteroids, emergency department/ urgent care visits, and hospitalizations) via monthly online sur-veys. Logistic regressions were performed using AIRQ control level (well-controlled [WC], not well-controlled [NWC], very poorly controlled [VPC]), age, sex, race, and body mass index as covariates and 1 or more and 2 or more exacerbations as the dependent variables (adjusted odds ratios [OR] and 95% Wald CIs). Kaplan-Meier analyses of time to first exacerbation by AIRQ control level were performed.RESULTS: A total of 1,112 patients were enrolled; 1,070 completed 1 or more surveys over 12 months (mean +/- SD 10.5 +/- 2.8 months); 70.5% female; age 43.9 +/- 19.3 years; 20.4% non-White; body mass index 30.6 +/- 8.7 kg/m2; AIRQ: WC 35.2%, NWC 38.1%, VPC 26.6%. A total of 45.7% of patients reported 1 or more exacerbations and 26.7% 2 or more exacerbations (WC 28.4% Z 1, 11.1% Z 2; NWC 46.3% Z 1,27.9% Z 2; VPC 67.7% Z 1, 45.6% Z 2). The ORs for 1 or more exac-erbations NWC versus WC were 2.1 (CI 1.6-2.9), and VPC versus WC were 4.6 (CI 3.3-6.5). The ORs for 2 or more exacerbations NWC versus WC were 3.1 (CI 2.1-4.6), and VPC versus WC were 6.1 (CI 4.0-9.1). Kaplan-Meier curves demonstrated clear differentiation of time to first exacerba-tion by AIRQ control level (P < .001).CONCLUSIONS: The AIRQ control level predicts exacerbation risk over 12 months and probability of time to first exacerbation.(c) 2022 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2022;10:3204-12)