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ASSESSING THE IMPACT OF ASTHMA CONTROL ON QUALITY OF LIFE IN PATIENTS WITH SEVERE OR DIFFICULT-TO-TREAT ASTHMA FREE TO VIEW

Hubert Chen, MD, MPH*; Paul D. Blanc, MD, MSPH; Tripthi Kamath, PhD; June H. Lee, MD; Sean D. Sullivan, PhD
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University of California San Francisco, San Francisco, CA



Chest. 2006;130(4_MeetingAbstracts):95S-d-96S. doi:10.1378/chest.130.3.890
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Abstract

PURPOSE: Optimal asthma control can be difficult to achieve. We assessed the impact of asthma control on quality of life in a population with severe or difficult-to-treat asthma.

METHODS: We analyzed data from 987 subjects, age ≥18 years, enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. Asthma control was assessed using the Asthma Therapy Assessment Questionnaire (ATAQ), a validated index of control problems ranging from 0 to 4. Disease-specific quality of life and preference-based health utilities were assessed 12 months later using the Mini-Asthma Quality of Life Questionnaire (AQLQ) and EuroQol 5-D (EQ-5D), respectively. ANOVA was used to test for an overall difference among the levels of asthma control. General linear models were used to adjust for the effect of asthma severity and FEV<SUB>1</SUB> on the AQLQ and EQ-5D.

RESULTS: Mean AQLQ score was 5.3 ± 1.2. Mean EQ-5D-derived utility was 0.86 ± 0.16. Greater number of asthma control problems was associated with worse disease-specific quality of life (AQLQ score: 5.9 ± 0.9 [0 problems] to 3.9 ± 1.1 [4 problems]; p<0.0001) and lower health utilities (EQ-5D index: 0.91 ± 0.13 [0 problems] to 0.73 ± 0.21 [4 problems]; p<0.0001) over 12 months of prospective follow-up. In multivariable analyses adjusted for asthma severity and FEV<SUB>1</SUB>, number of control problems was a significant predictor of the AQLQ (p<0.0001) and EQ-5D (p<0.0001) at follow-up.

CONCLUSION: Poorer asthma control is associated with substantial quality of life impairment. Asthma control predicts quality of life even after taking into account asthma severity and lung function.

CLINICAL IMPLICATIONS: Asthma therapy and management strategies should strive for achieving optimal asthma control.

DISCLOSURE: Hubert Chen, Grant monies (from industry related sources) HC is supported in part through a research fellowship grant in the amount of $85,000 to the University of California, San Francisco (Cardiovascular Research Institute) from Genentech, Inc.

Monday, October 23, 2006

2:30 PM - 4:00 PM


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