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Non-respiratory Symptoms and Well-Being in Asthmatics from a General Population Sample
Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, University, Uppsala.ORCID iD: 0000-0002-3944-8633
Ersta Sköndal University College, Department of Health Care Sciences, Stockholm.
Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala.
Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, University, Uppsala.
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2009 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 46, no 6, 552-559 p.Article in journal (Refereed) Published
Abstract [en]

Background. Different instruments have been developed to assess health-related quality of life (HRQL) in asthma patients. However, relatively few studies have assessed HRQL in asthma patients from a general population, and it is still unclear which instrument is most suitable. The purpose of this study was to compare HRQL in clinically verified asthmatics with subjects with respiratory symptoms without asthma and with subjects with no respiratory symptoms from a general population. The generic instrument Gothenburg Quality of Life (GQL) was used. A secondary aim was to study if GQL had any prognostic value in asthma.

Methods. A cohort of three age groups in Sweden was investigated in 1990 using a respiratory questionnaire and GQL. The cohort consisted of 616 subjects with asthma, 488 subjects with respiratory symptoms but no asthma, and 347 subjects without respiratory symptoms. The participants were also investigated by spirometry and allergy testing. In a follow-up study, subjects were identified who had persistent and improved asthma.

Results. The prevalence of 28 of the 30 common symptoms in GQL was significantly increased (p < 0.001) in subjects with asthma as compared to non-asthmatics. All symptoms in the domains heart and lung, head, musculoskeletal, tension, and depression were significantly increased among the asthmatics. The asthmatics also rated their physical well-being lower (p < 0.001) than subjects with no respiratory symptoms. Subjects with persistent asthma had a significantly higher prevalence of 7 of the 30 symptoms and lower social well-being than subjects showing improvement in asthma during the follow-up. All differences remained significant after adjusting for age, sex, and smoking habits.

Conclusion. Subjects with asthma had different symptom-profiles compared to those of non-asthmatics, with a higher prevalence of both respiratory and non-respiratory symptoms. Asthma is also a disease that is related to low well-being. The use of quality-of-life questionnaires such as the GQL may provide useful information for evaluating the non-respiratory aspects of asthma as well as for assessing the impact of disease on health status and well-being.

Place, publisher, year, edition, pages
Informa Healthcare, 2009. Vol. 46, no 6, 552-559 p.
Keyword [en]
asthma, GQL, quality of life
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:rkh:diva-523DOI: 10.1080/02770900902866743PubMedID: 19657894OAI: oai:DiVA.org:rkh-523DiVA: diva2:606944
Available from: 2013-02-21 Created: 2013-02-21 Last updated: 2017-05-17Bibliographically approved
In thesis
1. Health-related quality of life in asthma
Open this publication in new window or tab >>Health-related quality of life in asthma
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Health-related quality of life (HRQL) has become an important outcome in asthma, since traditional outcomes, such as respiratory symptoms and pulmonary function, might not entirely express the patient’s perception of the limitations caused by the disease. The aim of this thesis was to study HRQL in asthma and to analyse if HRQL was related to asthma onset and prognosis. Other aims were to identify determinants of low HRQL in clinically-verified asthmatics, and to study whether low HRQL was a predictor of mortality.

In 1990, a self-administered questionnaire was completed by 12,560 individuals from three age groups (16, 30-39, and 60-69 years) in two counties of Sweden. In a second phase, all subjects who reported a history of obstructive respiratory symptoms (n = 1,851) and 600 randomly-selected controls were invited to a clinical investigation including spirometry, allergy testing, and assessment of HRQL with the Gothenburg Quality of Life instrument. In 2003, the eligible subjects in the cohort (n=11,282) were sent a new questionnaire. Mortality data in the cohort was followed up during 1990–2008 using data from the National Board of Health and Welfare Mortality Database.

The 616 subjects with clinically-verified asthma 1990 had significantly lower HRQL than subjects without asthma. In the 2003 follow-up, the 305 subjects with persistent asthma had a lower HRQL than the 155 subjects who showed improvement in asthma during the follow-up. Subjects who had developed asthma by the follow-up had a significantly lower HRQL at baseline than those who did not develop asthma. Significant determinants of quality of life in asthma were female sex, smoking habits, higher airway responsiveness to irritants, respiratory symptom severity, positive skin prick test, and absenteeism from work or school. Low HRQL was related to increased mortality, but this association was not found when analyzing the asthmatic group alone.

In conclusion, measurements of HRQL are of value for evaluating both the impact and progression of asthma.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 71 p.
Keyword
asthma, adult, quality of life, cohort studies, longitudinal study, questionnaires, epidemiology, prognosis, Gothenburg quality of life instrument
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-532 (URN)978-91-554-7864-3 (ISBN)
Public defence
2010-10-02, Hörsalen, Akademiska sjukhuset, Dag Hammarskjölds väg 17, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Note

medicine doktorsexamen

Available from: 2014-07-08 Created: 2013-02-25 Last updated: 2017-05-17Bibliographically approved

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