Long-term change in health-related quality of life in patients with asthma

Abstract

The aim of this study was to investigate long-term change in health-related quality of life (HRQL) in patients with asthma in real clinical practice and in relation to emotional disorders, cooperativeness (cooperation between the patient and the physician, and adherence to treatment), and cold air-provoked bronchial hyperresponsiveness (BHR).Methods. This observational study involved 32 patients with mild to moderate asthma. The study duration was 7.5 to 10 years. HRQL was assessed using SF-36 questionnaire and Asthma Quality of Life Questionnaire (AQLQ); emotional disorders were diagnosed using Hospital Anxiety and Depression Scale (HADS). Patients’ cooperativeness assessment was based on number of a patient’s scheduled visits to a physician during the study. The asthma control level was evaluated using the Asthma Control Test (ACT).Results. A significant worsening was found in the social activity domain of HRQL in the total group of the patients. According to AQLQ, a significant improvement was seen in the activity and symptoms domains and in the total score of quality of life (QoL). Long-term pharmacological treatment of asthma decreased anxiety and depression levels. The asthma control (ACT score) increased from 13.2 ± 1.0 to 19.7 ± 1.1 (р = 0.00003). Anxiety and depression decreased in patients with high cooperativeness during the long-term follow-up, while the total QoL and the specific QoL were unchanged excluding the social activity domain. A significant worsening in the activity scale and in the emotional scale of specific QoL together with growing depression and decreasing control of asthma were found in patients with lower cooperativeness. The cold air-provoked BNR slowed down the long-term improvement in the social activity domain. The cold air-provoked BNR also decreased patient-reported evaluation of daily activity.Conclusion. The long-term basic therapy of asthma provides a positive trend in HRQL in the real clinical practice independently on worsening of the disease. Lower cooperativeness of a patient could decrease specific QoL, which, in turn, worsens the control of asthma and contributes to negative emotional background and destructive behavior.