Subjects with well-controlled asthma have similar health-related quality of life as subjects without asthma

Jansson, Sven-Arne; Axelsson, Malin; Hedman, Linnéa; Leander, Mai; Stridsman, Caroline; Rönmark, Eva

doi:10.1016/j.rmed.2016.09.019

Cited by 18 publications

(23 citation statements)

References 40 publications

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“…According to Stephen et al () nursing‐led intervention in primary care, such as support to quit smoking, increased physical activity, or weight management can reduce lifestyle risk factors and improve health outcomes. Overall in our study, 10% of the individuals with asthma were daily smokers, with higher prevalence among women than among men, similar to other studies from the Nordic countries (Jansson et al, ; Tollefsen et al, ). Smoking was associated with uncontrolled asthma, also after adjustment for covariates.…”

Section: Discussionsupporting

confidence: 92%

“…ACT is shown to be a reliable and valid tool for evaluating and discriminating asthma control (Nathan et al, ), with high internal consistency reliability (Axelsson et al, ; Nathan et al, ). ACT is also commonly used in Swedish studies (Axelsson et al, ; Jansson et al, ; Stridsman et al, ). Furthermore, the prevalence of current asthma in our study is in line with previous reports (Lötvall et al, ), which strengthens the generalizability of our results.…”

Section: The Studymentioning

confidence: 99%

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Asthma control and acute healthcare visits among young adults with asthma—A population‐based study

Selberg¹,

Hedman

Jansson

et al. 2019

Journal of Advanced Nursing

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Aims To study asthma control and acute healthcare visits among young adults with asthma. Background Despite the access to effective treatment and nursing interventions, poor asthma control is still common among individuals with asthma. However, studies describing clinical characteristics among young adults with asthma are rare. Design A population‐based cohort study. Methods In 2015, as a part of the OLIN paediatric cohort I (recruited in 1996 at age 7–8 years), N = 2,291 young adults (27–28 years) completed a postal questionnaire survey including questions on asthma and respiratory symptoms. Of these, N = 280 (12%) were identified as having current asthma and were further studied. Results Of those with current asthma, women reported respiratory symptoms and smoking to a greater extent than men. Approximately one‐fourth had uncontrolled asthma and acute healthcare visits due to asthma was reported by 15% of women and 8% of men. Uncontrolled asthma was associated with smoking, lower educational level, use of reliever treatment most days, and acute healthcare visits. Acute healthcare visits due to asthma were associated with periodic use of regular controller treatment also after adjustment for uncontrolled asthma. Conclusion The result indicate poor adherence to asthma treatment which may lead to decreased asthma control and acute healthcare visits. Impact Most young adults with asthma are diagnosed and treated in primary care, ideally in a team with a nurse. The main findings highlight the need for evidenced‐based nursing interventions, contributing to a more efficient asthma management in primary care.

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Section: Discussionsupporting

confidence: 92%

Section: The Studymentioning

confidence: 99%

Asthma control and acute healthcare visits among young adults with asthma—A population‐based study

Selberg¹,

Hedman

Jansson

et al. 2019

Journal of Advanced Nursing

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“…Fig 3 shows the distance between our sample and reference norms according to asthma control. These findings are in agreement with the 2008 European National Health and Wellness Survey [ 15 ] and a randomly selected cohort with clinical examination [ 38 ], in which well-controlled asthma patients presented similar SF-12 scores to the general population.…”

Section: Discussionsupporting

confidence: 89%

Impact of asthma on women and men: Comparison with the general population using the EQ-5D-5L questionnaire

et al. 2018

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BackgroundThe aim was to evaluate the impact of asthma on patients’ Health-Related Quality of Life (HRQoL) by comparing asthmatic women and men with reference norms, to examine the factors which contributed to an impaired HRQoL, and to identify groups at higher risk.MethodsCross-sectional evaluation of 222 primary care patients with persistent asthma (18–40 years old). HRQoL impact was estimated with the EuroQol-5 Dimensions (EQ-5D), which allows calculating Quality-Adjusted Life-Years (QALYs) by applying society preferences. Participants self-completed the EQ-5D questionnaire online. Telephonic interviews collected information on medication and adherence, and administered the Asthma Control Questionnaire. Severity markers included asthma-related comorbidity, previous oral corticosteroids course prescription, and inhaled corticosteroids daily dose. After bivariate analyses, multiple linear regression models were constructed to examine the relations between HRQoL asthma impact and socio-demographic and clinical variables, using as dependent variable the deviation from general population-based EQ-5D reference norms.ResultsDeviation from the EQ-5D index norms was moderate in most age/gender groups (-0.1, which corresponds to 0.6 standard deviations), while it was large in women aged 18–24 years (-0.18, corresponding to 1.1 standard deviations). In regression models, a poor asthma control was the only factor independently associated to HRQoL impact in both women and men: β -0.18 (p<0.001) and -0.15 (p = 0.01) respectively. Translating these β coefficients to QALYs, they are interpretable as 66 fewer days of full health per year in women with uncontrolled asthma and 55 for men, compared with those with controlled asthma.ConclusionPersistent asthma has a moderately negative HRQoL impact on patients of both genders, and the youngest women have been identified as a high risk group which merits further research. We identified asthma control as the major contributor to impaired HRQoL in patients, regardless of their gender, suggesting that asthma HRQoL impact could be alleviated by achieving a good control of symptoms.

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“…We have previously shown that adults with wellcontrolled asthma report similar health status as those without asthma (32). Others have shown that poor asthma control is related to worse health status, together with factors as advancing age and lower educational level (33).…”

Section: Discussionmentioning

confidence: 91%

Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health – a report from the OLIN adult asthma cohort

et al. 2020

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Objective: To study asthma exacerbations, healthcare utilization and health status among subjects with asthma with different treatment regimens and levels of asthma control. Methods: In 2012-2014, n ¼ 1425 adults from a population-based asthma cohort within the OLIN studies (Obstructive Lung disease in Northern Sweden) were invited to a follow-up including spirometry and a structured interview, n ¼ 1006 participated. Asthma Control Test (ACT) was used to detect uncontrolled asthma, and physical and mental dimensions of health were measured with SF-8. Pharmacological treatment use was classified by Global Initiative for Asthma treatment steps. Out of n ¼ 830 with current asthma, n ¼ 714 answered ACT (57% women, 32-92 years) and were included in the study. Results: Uncontrolled asthma increased per treatment step (no treatment 9.9%, treatment step 1-3 24.1%, and treatment steps 4-5 39.9%, p < 0.001). A higher proportion of subjects with uncontrolled asthma reported exacerbations, healthcare utilization, and worse health status than those with controlled asthma. The proportion of subjects reporting exacerbations, healthcare visits, emergency room visits and regular follow-up visits increased per treatment step. Worse health was associated with uncontrolled asthma, but not with the level of treatment. A higher proportion of women than men reported exacerbations, any healthcare visits, and lower health. Regular follow-up visits to a physician were uncommon (women 21.2% vs. men 14.6%, p ¼ 0.022). Conclusions: Uncontrolled asthma is common in all treatment steps, and is associated with worse health status. However, health status did not differ by treatment steps. Identifying subjects with uncontrolled asthma regardless of treatment regimens should be a priority, thus follow-up visits are important.

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Subjects with well-controlled asthma have similar health-related quality of life as subjects without asthma

Cited by 18 publications

References 40 publications

Asthma control and acute healthcare visits among young adults with asthma—A population‐based study

Asthma control and acute healthcare visits among young adults with asthma—A population‐based study

Impact of asthma on women and men: Comparison with the general population using the EQ-5D-5L questionnaire

Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health – a report from the OLIN adult asthma cohort

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