PURPOSE: To compare health-related quality of life (HRQOL) between controlled and uncontrolled asthma patients and to assess the HRQOL impact of uncontrolled asthma pediatric patients on their caregivers.
METHODS: Patients enrolled in the National Jewish Medical and Research Center Disease Management program for asthma from 1996 to 2006 were classified as having uncontrolled asthma based on the following criteria upon program entry: (1) taking a controller medication and (2) satisfying at least one of the following: (i) hospitalization or ER visit within the last 6 months; (ii) symptoms ≥3 nights/month; or (iii) daily or continual asthma symptoms. All other patients were classified as having controlled asthma. At program entry, HRQOL was assessed in adults using the Marks Asthma Quality of Life Questionnaire (AQLQ) and in caregivers of children with asthma using the Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ). Comparisons in AQLQ and PACQLQ total and subscale scores were made between children, adults, and caregivers of pediatric patients with controlled and uncontrolled asthma. Differences in median scores were compared using the Wilcoxon-Mann-Whitney test.
RESULTS: Of the 40,617 patients enrolled in the program, 9,417 had HRQOL data and were classified on initial assessment as controlled (4,144 adults; 1,022 children/caregivers) or uncontrolled (3,730 adults; 521 children/caregivers). Uncontrolled adults had higher total AQLQ scores (1.3 points) and subscale scores (breathlessness=1.4 points; mood=1.0 point; social=1.3 points; concerns=1.2 points), indicating lower HRQOL (P<0.001 for all). The total and both emotional function and activity limitation PACQLQ subscales scores for caregivers of children with uncontrolled asthma were 0.5 points lower than for caregivers of children with controlled asthma (P<0.001 for all).
CONCLUSION: Uncontrolled asthma was associated with a reduced HRQOL among adult patients and among caregivers of pediatric patients with uncontrolled asthma. Differences between controlled and uncontrolled asthma patients and caregivers of pediatric patients met or exceeded published criteria considered minimally and clinically significant.
CLINICAL IMPLICATIONS: Adequately treating and controlling asthma symptoms can improve the quality of life of adult patients and caregivers of pediatric patients.
DISCLOSURE: Lawrence McDermott, No Product/Research Disclosure Information; Employee Rezaul Khandker, Songkai Yan, Vincent Ciuryla, and Lawrence McDermott are employees of Wyeth Research. Brian Calimlim and Bonnie Dean are employed by Cerner LifeSciences, which provides consulting services to Wyeth Research.