The following is a summary of “Patient-Reported Symptom and Health-Related Quality-of-Life Validation and Responsiveness During the First 6 Months of Treatment for Mycobacterium avium Complex Pulmonary Disease,” published in the July 2023 issue of the Chest by Henkle et al.

Chronic pulmonary disease is caused by nontuberculous mycobacteria (NTM), predominantly the Mycobacterium Avium complex (MAC). Important treatment outcomes include improvements in symptoms and health-related quality of life (HRQoL), but no validated patient-reported outcome (PRO) measure exists. During the first six months of MAC pulmonary disease (MAC-PD) treatment, what are the validity and responsiveness of the Quality of Life-Bronchiectasis (QOL-B) questionnaire respiratory symptoms scale and essential HRQoL measures? Comparison of Two- versus Three-antibiotic Therapy for Pulmonary Mycobacterium Avium Complex Disease (MAC2v3) is an ongoing, multisite, randomized, pragmatic clinical trial. The treatment groups were combined for this analysis. PROs were assessed at baseline, 3, and 6 months. Separate studies were conducted on the QOL-B respiratory symptoms, vitality, physical functioning, health perceptions, and NTM symptom domain scores (0-100, with 100 being the highest). 

The enrolled population was subjected to psychometric and descriptive analyses, and the minimal significant difference (MID) was calculated using distribution-based methods. Finally, using paired t-tests and latent growth curve analysis, the researchers assessed the responsiveness of the subset of longitudinal surveys completed at the time of examination. The population at baseline consisted of 228 patients, 144 of whom had completed longitudinal surveys. Most patients were female (82%) and had bronchiectasis (88%); 50% were at least 70. The respiratory symptoms domain exhibited excellent psychometric properties (no floor or ceiling effects; Cronbach’s = 0.85) and a MID ranging from 6.4 to 6.9. 

The scores for the vitality and health perceptions domains were comparable. At 3 and 6 months, respiratory symptoms domain scores increased by 7.8 points (P<.0001) and 7.5 points (P<.0001), and physical functioning domain scores increased by 4.6 points (P<.003) and 4.2 points (P =.01). A three-month analysis of latent growth curves revealed a nonlinear, statistically significant improvement in respiratory symptoms and physical functioning domain scores. The QOL-B respiratory symptoms and physical functioning scales exhibited acceptable psychometric properties in patients with MAC-PD. Three months after the initiation of treatment, respiratory symptom scores exceeded the MID.

Source: sciencedirect.com/science/article/abs/pii/S001236922300260X