Severe asthma and quality of life

Abstract

Severe asthma has a great impact on the quality of life (QOL) of patients and their families. The magnitude of this morbidity is affected by several personal factors including age. Appropriate asthma control and modifications of social roles and activities are expected to improve QOL. Biologics, primarily monoclonal antibodies, have been developed to target specific pathways and molecules important in the pathogenesis of asthma. The use of biologics has shown some promising effects on the QOL of patients with severe recalcitrant asthma. Other potential measures involve targeting risk factors and comorbidities and improving the levels of adherence to therapy. This article briefly reviews the impact of severe asthma on QOL and the potential methods to combat this morbidity including the available therapeutic biologics.

The impact of severe asthma on patients’ autonomy: A qualitative study

“…Preserving the “self” in severe asthma becomes harder when there is a constant struggle to fight the debilitating physical effects of the illness and side‐effects of its treatment, and the identifications that come with the diagnosis. When trying to maintain and preserve “self” in the face of illness, individuals acknowledged the emotional cost associated with their efforts in preserving “normality.” Previous quantitative and qualitative researches on patients’ experiences with severe asthma note that its debilitating and unpredictable symptoms, the side‐effects of treatment and the burden on their quality of life can ultimately have emotional consequences, but there is a lack of in‐depth psychological research furthering our understanding of how people living with severe asthma perceive their condition and how they behave when challenged in a range of situations. Our findings attempt to broaden and challenge the biomedical model, and highlight that asserting autonomy to preserve their sense of “normality” and sense of self might also lead to unwanted outcomes.…”

Health‐related quality of life burden in severe asthma

“…Additionally, a review and meta‐analysis 53 noted a large placebo effect for the non‐intervention arms of the reviewed drug trials. This review, however, did not have a specific severe asthma focus, 53 where HRQoL is more significantly impaired 54 …”

“…This review, however, did not have a specific severe asthma focus, 53 where HRQoL is more significantly impaired. 54 Over 25% of people with severe asthma take maintenance oral corticosteroids. 36 This corticosteroid-dependent group have poorer HRQoL and more comorbidities than those with severe asthma who are not corticosteroid-dependent.…”

Clinical and lung function outcomes in a cohort of children with severe asthma

“…It could be hypothesised that the nurse-led assessment was an effective means to identify treatment difficulties more effectively. Indeed the "simple" steps of checking for adherence to therapy concurrent with asthma education can markedly improve asthma control and promote a better quality of life for some patients [8,26,27]. Our analysis was not appropriately controlled to provide high-level evidence for a beneficial effect of a nurse-led SAC on outcomes.…”

“…Comorbidities adversely affecting asthma control include obesity, allergic rhinitis, psychosocial factors, and obstructive sleep apnoea [7]. SA has a great impact on the quality of life (QOL) of children [8]. Management of uncontrolled SA may require a personalised treatment approach that involves a multidisciplinary team and is informed by a comprehensive set of clinical assessments.…”