Comprehensive Tool Measures Burden of Chronic Conditions: COPD, Asthma, and Diabetes

A new compressive tool in the Netherlands offers physicians a reliable way to measure burden of chronic conditions, such as chronic obstructive pulmonary disease (COPD), asthma, and type 2 diabetes (T2D).

“To our knowledge, this is the first study of a questionnaire that combines the experienced burden of disease for people with COPD, asthma, or T2D into a single questionnaire,” wrote the researchers. “The validity and reliability of the ABCC [Assessment of Burden Chronic Conditions] scale for these conditions separately justify investigation of its psychometric properties for people with multimorbidity.”

The results of this cross-sectional questionnaire study were published in The Annals of Family Medicine.

Self-management is crucial to the overall management of chronic conditions, which has a huge impact on health care and especially people living with these conditions. However, most questionnaires used to assess the burden of people’s chronic conditions is based on measuring quality of life, failing to provide a full representation of burden of disease from multiple, chronic conditions.

The researchers of this study designed the ABCC tool to measure burden of disease and offer burden-guided care plans to patients in a clinical setting.

All participants were asked to take the self-reported, at-home ABCC scale questionnaire, which included questions about baseline characteristics of their chronic condition.

Additionally, all participants were asked to answer questionnaires from either the Saint George Respiratory Questionnaire for patients with COPD, the Standardized Asthma Quality of Life Questionnaire for patients with asthma, or the Audit of Diabetes-Dependent Quality of Life Questionnaire for patients with T2D.

Two weeks after competition of the first questionnaire, the participants were asked to take the ABCC scale again, with additional questions concerning any changes from baseline score.

The study included a total of 65 patients with COPD, 62 with asthma, and 60 with T2D. The ABCC scale showed higher validity in 75% of the comparisons with the Saint George Respiratory Questionnaire, 100% of the comparisons with the Standardized Asthma Quality of Life Questionnaire, and 75% of the comparisons with the Audit of Diabetes-Dependent Quality of Life Questionnaire.

The researchers found that the ABCC scale was internally consistent for distinguishing across chronic condition groups with a Cronbach’s a of 0.90 for people with COPD, 0.92 for asthma, and 0.91 for T2DM, respectively. Additionally, the scale and had good test-retest reliability with with an intraclass correlation coefficient of 0.95 for people with COPD, 0.93 for asthma, and 0.95 for T2D, respectively.

Patients with 2 or more exacerbations scored significantly higher on the ABCC scale total. For instance, people with COPD and depression scored significantly higher on the ABCC scale total, as well as on the domains for fatigue, feelings and emotions, and relations and work.

The researchers acknowledge some limitations to their study, including a small population size among chronic condition groups. However, they support the validity of this assessment in its ability to identify and evaluate burden of disease among patients with chronic conditions.

“The ABCC scale is a brief self-administered questionnaire that measures the experienced burden of disease for people with COPD, asthma, or T2D,” wrote the researchers. “This study provides evidence for the validity and reliability of the ABCC scale in a Dutch population.”

Reference

1. Annfammed. A comprehensive tool measuring burden of chronic conditions shows valid and reliable results compared to clinical surveys in patients with COPD, diabetes, asthma. EurekAlert! https://www.eurekalert.org/news-releases/984197. Published March 28, 2023. Accessed April 6, 2023.

2. Claessens D, Boudewijns EA, Keijsers LC, Gidding-Slok AH, Winkens B, van Schayck OC. Validity and reliability of the assessment of burden of chronic conditions scale in the Netherlands. The Annals of Family Medicine. 2023;21(2):103-111. doi:10.1370/afm.2954