Development and validation of the inhaled corticosteroid questionnaire : a model for the measurement of patient-perceived side effects by self-report

Inhaled corticosteroids are effective treatments in asthma and in some cases of chronic obstructive pulmonary disease. Unfortunately these medications are associated with commonly occurring side effects such as dysphonia (problems with the voice) or skin bruising. Some patients will stop taking inhaled corticosteroids as a result of side effects. Failure to take these medications can lead to worse respiratory health, increased economic burden (e.g. lost work days and increased health care costs). Research suggests that the side effects of inhaled corticosteroids may not be routinely addressed during clinical consultations, by doctors or patients. Furthermore studies which aim to investigate the effectiveness of inhaled corticosteroid treatments may fail to adequately measure patients' experiences of the side effects of these treatments. A questionnaire about inhaled corticosteroid-related side effects, designed to be completed by the patient, could therefore be of considerable use in research and clinical settings. In this thesis we developed the Inhaled Corticosteroid Questionnaire (ICQ), a patient-reported measure of the side of inhaled corticosteroids.