A new instrument for the assessment of patient-defined benefit in the treatment of allergic rhinitis.
BACKGROUND
Allergic rhinitis (AR) is a common disease that affects health-related quality of life (HRQoL). Current and future health policy demands the assessment of patient-relevant treatment benefit for evaluation of treatments.


METHODS
We developed, validated and tested a standardized instrument for the assessment of patient-relevant needs and benefits in AR. In an open survey of patients with AR, 100 need and benefit items were generated. The items were condensed to a 25-item list by an expert panel. On this list, patient rates the personal importance of 25 treatment needs on a scale ranging from 'not at all' to 'very' before treatment (Patient Needs Questionnaire, PNQ). At the end of the treatment, patient rates the extent, to which these needs were achieved by treatment from 'did not help at all' to 'helped a lot' (Patient Benefit Questionnaire). The patient benefit index (PBI) is computed to provide a global weighted benefit parameter. This disease-specific instrument was validated in n = 104 patients with AR.


RESULTS
The PBI-AR showed good acceptability and feasibility in clinical routine. Reduction in nose and eye symptoms was rated most important. The PBI amounted to 2.2 (PBI ranges from 0 = 'no benefit' to 4 = 'maximum benefit'). Reliability of the PNQ was high (Cronbach's alpha = 0.9).The PBI was significantly correlated with relevant external validation criteria, such as patient satisfaction (R = 0.54) and HRQoL (R = 0.26).


CONCLUSIONS
The PBI-AR is a feasible, reliable and valid instrument for the standardized assessment of patient-relevant benefits in the treatment of AR.
CVderm - German Center for Health Services Research in Dermatology, Institute for Health Services Research in Dermatology, University Clinics of Hamburg Dermatologikum Hamburg, Berlin, Germany. n.franzke@uke.uni-hamburg.de
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N
Franzke
I
I
Schäfer
K
K
Jost
C
C
Blome
S J
SJ
Rustenbach
K
K
Reich
M
M
Reusch
M
M
Maurer
M
M
Augustin
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy / Q000523:psychology*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome; D055815:Young Adult