Generic health-related quality of life in patients with bronchial asthma

Kim, Cheol Woo; Chung, Hye Won; Shin, Jae In; Bae, Sang Woon; Park, Jung Won; Cho, Seung Yun; Hong, Chein Soo

Abstract

BACKGROUND AND OBJECTIVE: It is recommend that health-related quality of life (HRQL) should be measured as well as conventional clinical indices in order to obtain a complete picture of a patient's health status. In patients with bronchial asthma, frequent symptoms and management related burdens may result in reduced HRQL. In Korea, asthma-specific quality of life (QOL) questionnaire has been developed and broadly applied in clinical practice. But little is known about the impact of asthma on generic HRQL. In this study, we evaluated the generic HRQL in adult asthmatic patients by using the Nottingham Health Profile (NHP).
METHODS
Two-hundred three subjects with age over 40 years were enrolled in this study; 77 hospital out-patients with asthma, 63 with stable ischemic heart disease (IHD), 26 hospitalized patients with unstable IHD such as unstable angina or acute myocardial infarct (MI), and 37 healthy controls. All subjects were asked to answer the NHP by self-administration method. The NHP was composed of two parts. Part I consisted of 38 items in six domains and part II 7 items. Six domains of part I were physical mobility (8 items), pain (8 items), social isolation (5 items), emotional reaction (9 items), energy level (3 items) and sleep (5 items).
RESULTS
Although patients with unstable IHD had most significant problems in all area of the NHP part I and II, bronchial asthmatics had similar or more restriction to patients with stable IHD. Patients with asthma also had significantly more problems of generic HRQL than healthy controls. Patients with more severe asthma suffered from more pain and loss of energy than mild asthmatics. In similar severity of asthma, patients with lower economic state had more restriction, especially in pain and emotional reaction. Patients with asthma experienced difficulties with daily activities in the NHP part II in order of holidays, work, home relationships, homework, hobbies, social life, sex life, and had more problems with their home work and home relationships than patients with stable IHD.
CONCLUSION
Patients with bronchial asthma had similar or more restriction to patients with stable IHD in generic HRQL. To improve outcome measurement of asthma treatment, generic HRQL should be measured as well as asthma-specific QOL and clinical indices.