The Voice of the Patient

Abstract: Allergic diseases, which constitute a global health problem, have been defined as one of the epidemics of the twenty-first century. Since there are no cures for allergic diseases today, the goal of treatment is to get the disease under control so that the patient can live a normal life with optimal chances of development. Patient-reported outcomes for control assessment have been a focus of attention since no laboratory test or physical examination can do this alone in a reliable manner. The aim of this thesis was to develop patient-reported outcomes (PRO) for clinical evaluation in regard to respiratory allergic disease. Two PROs were validated. The first questionnaire was a disease-specific, health- related quality of life questionnaire that had been developed in England for children with multiple allergic diseases. We translated the questionnaire into Swedish and validated it for children with a grass pollen allergy. The second instrument is a novel tool for asthma assessment in primary care developed with the goal of structuring asthma review in primary care. The result showed that it can be useful for assessing asthma control as well. The burden of allergic disease was assessed in children with a grass pollen allergy during pollen season. The result showed that the health-related quality of life was impaired and that the patients were affected both physically and mentally. We also propose new limits for pollen prognosis that would be easy for children to understand, in this case presented as a traffic light model with green, yellow and red lights. In conclusion, this thesis shows that respiratory allergies can affect the health-related quality of life. We believe, since the goal of our treatment is to improve the patient's daily life, that PRO measurements can be helpful both in research and in clinical practice.