Health-Related Quality of Life in Patients With Asthma and Allergies

peanut allergy, asthma inhaler
peanut allergy, asthma inhaler

The presence of persistent asthma and comorbid allergies has been linked to a significant adverse impact of certain measures of health-related quality of life (HRQoL). A retrospective analysis was conducted of patient survey responses and administrative pharmacy claims from the Observational Study of Asthma Control and Outcomes (OSACO), and the results were published in the Journal of Asthma.

In Colorado, the investigators sought to evaluate the HRQoL and healthcare resource usage in a managed care population of patients with asthma who were either diagnosed with or without comorbid allergies. Between April 2011 and December 2012, patients ≥12 years of age with persistent asthma received 4 identical surveys. The presence of allergy was identified by a positive response to the following question: “In the last 6 weeks, have you experienced hay fever or seasonal allergies?” and ≥1 diagnosis-related International Classification of Diseases, Ninth Revision code(s) for allergic conditions.

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The HRQoL measures used for comparison purposes included a generic preference-based health status classification (EQ-5D-3L [together with a visual analog scale]), an asthma-specific preference-based health status classification (AQL-5D), and an asthma-specific health status instrument  (Mini Asthma Quality of Life Questionnaire [MiniAQLQ]).

Of the 2681 individuals with asthma who completed the initial survey in the OSACO study, 971 had comorbid allergies. Following the adjustment for covariates, patients with asthma and comorbid allergies had significantly lower total MiniAQLQ scores compared with patients with asthma, but without allergies (–0.489; 95% CI, –0.570 to –0.409; P < .01). In fact, in patients with asthma and comorbid allergies, HRQoL scores were significantly lower across all 4 domains of the MiniAQLQ, with the worst score reported for the environmental stimuli domain (–0.729), followed by the symptoms domain (–0.552).

In addition, the asthma-specific AQL-5D index score was significantly lower in patients with asthma and comorbid allergies compared with patients with asthma and no allergies (–0.036; 95% CI, –0.042 to –0.029; P < .01). Utility scores were also significantly lower on the EQ-5D in patients with asthma and comorbid allergies than in patients with asthma without allergies (–0.031; 95% CI, –0.047 to –0.015; P < .01).

The investigators concluded that the coexistence of allergies and persistent asthma is associated with a significant deleterious impact on several measures of HRQoL. Because of the harmful effect of allergies on HRQoL in patients with asthma, appropriate testing for allergic conditions in this population is critical.

Sullivan PW, Kavati A, Ghushchyan VH, et al. Impact of allergies on health-related quality of life in patients with asthma. J Asthma. 2019 Jul 16:1-16.