Impact of Changes in Asthma Severity on Health-Related Quality of Life in Pediatric and Adult Asthma Patients: Results from The Asthma Outcomes Monitoring System

Abstract

The goals of asthma treatment have broadened beyond managing traditional clinical markers of disease severity, and now include a focus on benefits of treatment in terms that are most meaningful to patients. Measurement of both generic and disease-specific health-related quality of life (HQL) is advocated because each provides complementary information about how the condition affects everyday functioning and well-being and whether treatments have their intended effects. The purpose of this study was to determine the impact of changes in asthma severity (defined using NHLBI/NAEPP severity staging) on patient-assessed HQL. Two hundred and thirty-three pediatric asthma patients and 269 adult asthma patients were evaluated in a one-year observational study. Analyses were performed to compare the generic and asthma-specific scores for patients whose asthma severity improved, stayed the same, or worsened over one year. The asthma-specific scales are sensitive to changes in disease severity. Of the generic scales, those tapping areas of physical health are more affected than the mental/emotional scales. This confirms that HQL measures are responsive to changes in asthma severity. They complement traditional clinical markers used to evaluate changes in a patient's disease state and thus give the physician another useful tool in following the clinical progress of the child with asthma.

Asthma control, severity, and quality of life: Quantifying the effect of uncontrolled disease

“…Specifically, this analysis demonstrates a direct inverse relationship between the number of control problems and HRQoL in asthma. Although previous research has shown an association between asthma severity and HRQoL, 16,17 our results demonstrate that asthma control manifests an influence on HRQoL, even when GINA classification and lung function (ie, measures of severity) are taken into consideration. Our findings lend support to the proposition that asthma severity and asthma control, albeit interrelated concepts, each contribute independently to HRQoL.…”

The Asthma Therapy Assessment Questionnaire (ATAQ) for Children and Adolescents

“…There is evidence that some of the questions in ATAQ tap into important information that is not captured by existing measures, such as the Asthma Outcomes Monitoring System, which is concerned with healthrelated quality of life. 18 For example, the questions about whether the child uses controller medications daily and the child's ability to take medications are not addressed in other questionnaires. This is reflected in the limited set of significant correlations of responses to these questions with other questionnaires to measure asthma symptoms and problems.…”

A Health-Related Quality-of-Life Comparison of Formoterol (Oxis^®) Turbuhaler^® plus Budesonide (Pulmicort^®) Turbuhaler^® with Budesonide Turbuhaler^® Alone and Noncorticosteroid Treatment in Asthma: A Randomized Clinical Study in Russia

“…They provide valuable and complementary information on everyday functioning and well-being, and whether the treatments have their intended effect [6, 7]. …”