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

Gimena Hernandez, Alexandra L. Dima, Àngels Pont, Olatz Garin, Marc Martí-Pastor, Jordi Alonso, Eric Van Ganse, Laurent Laforest, Marijn de Bruin, Karina Mayoral, Montse Ferrer, ASTRO-LAB group

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Background: The 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. Methods: Cross-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. Results: Deviation 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. Conclusion: Persistent 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.
Original languageEnglish
Article numbere0202624
Number of pages18
JournalPloS ONE
Issue number8
Publication statusPublished - 23 Aug 2018

Bibliographical note

Financial support for this study was provided by the European Union Seventh Framework Programme FP7 (ASTROLAB project EC HEALTH-F5-2011-282593) to EVG, Instituto de Salud Carlos III FEDER (PI12/00772) to JA, and DIUE of Generalitat de Catalunya (2014 SGR 748) to MF. The funding agreement ensures the authors’ independence in designing the study, interpreting the data, writing and publishing the report.

S1 Dataset. Study anonymized dataset.


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