Evaluating change in health-related quality of life in adult rhinitis: responsiveness of the Rhinosinusitis Disability Index.
BACKGROUND
The Rhinosinusitis Disability Index (RSDI) is a validated measure of health-related quality of life (HRQL) in rhinitis. Responsiveness of the RSDI to changes in health status over time has not been described.


METHODS
We studied adults with a self-reported physician diagnosis of rhinitis identified through a national telephone survey. HRQL was assessed at baseline and at 24 months using the RSDI. Symptom severity, physical health status (SF-12 PCS), psychological mood (CES-D), and perceived control of symptoms were also assessed at the time of each interview. In addition, we ascertained specific health outcomes attributed to rhinitis, including days of restricted activity, job effectiveness, number of physician visits, and medication costs.


RESULTS
Of 109 subjects interviewed at baseline, 69 (63%) were re-interviewed 24 months later. RSDI scores improved by = 0.5 standardized response mean in 13 (19%) subjects and worsened in 17 (25%). Change in the RSDI over time correlated with changes in symptom severity (r = 0.38, p = 0.001), physical health (r = -0.39, p = 0.001), mood (r = 0.37, p = 0.002) and perceived control of symptoms (r = -0.37, p = 0.01). In multivariate analyses adjusted for baseline health status, improvement in RSDI was associated with less restricted activity (p = 0.01), increased job effectiveness (p = 0.03), and decreased medication costs (p = 0.05), but was not associated with change in the number of physician visits from baseline (p = 0.45).


CONCLUSIONS
The RSDI is responsive to changes in health status and predicts rhinitis-specific health outcomes.
Chen
Hubert
H
Department of Medicine, University of California, San Francisco, CA, USA. hubert.chen@ucsf.edu
Katz
Patricia P
PP
Shiboski
Stephen
S
Blanc
Paul D
PD
D000293:Adolescent; D000328:Adult; D002140:California; D004185:Disability Evaluation; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life; D012220:Rhinitis / Q000188:drug therapy / Q000503:physiopathology*; D012651:Self Medication / Q000191:economics; D018434:Sickness Impact Profile; D012852:Sinusitis / Q000188:drug therapy / Q000503:physiopathology*