Development of the Six-Item Long-Term Asthma Control Questionnaire: a Questionnaire for Assessing Long-Term Asthma Control

BACKGROUND: Existing asthma questionnaires rely on short recall periods and may not capture symptom burden across typical follow-up intervals. A brief instrument that summarizes longer-term asthma control may support risk stratification and remission-oriented care. OBJECTIVE: To develop a brief questionnaire that assesses symptom burden over a 3-month recall period and evaluate its performance in identifying Asthma Control Test (ACT)-defined, well-controlled asthma. METHODS: Ninety adults with asthma completed a questionnaire, the six-item Long-Term Asthma Control Questionnaire (LAQ-6), and the ACT in an outpatient setting. We performed correlation and receiver operating characteristic curve analyses to evaluate associations with ACT-defined well-controlled status (ACT ≥20). We assessed confirmed exacerbations and emergency visits over an approximately 6-month observation window using receiver operating characteristic curve analyses and prespecified cutoffs. RESULTS: The LAQ-6 strongly correlated with the ACT (r = 0.79; P < .001) and asthma-related quality of life assessed using mean Asthma Quality of Life Questionnaire scores (Spearman's ρ = 0.763; P < .001). It achieved an area under the curve of 0.83 in identifying ACT-defined well-controlled status (ACT ≥20) (95% CI, 0.72-0.94). For 6-month outcomes, the LAQ-6 achieved higher areas under the curve than the ACT for exacerbations (0.866 vs 0.816) and emergency visits (0.857 vs 0.676). Exacerbations and emergency visits were more frequent in patients with LAQ-6 scores below the prespecified cutoff (<27). CONCLUSIONS: The LAQ-6 is a brief 3-month recall questionnaire complementing existing short-recall tools. It may facilitate rapid assessment of longer-term symptom burden and risk stratification in outpatient practice, supporting evaluation of clinical remission.