Allergy and Respiratory Disease Clinic, Ospedale S. Martino Genoa, Genoa, Italy.
PLoS One. 2012;7(2):e31178. doi: 10.1371/journal.pone.0031178. Epub 2012 Feb 17.
Asthma trials suggest that patients reaching total disease control have an optimal Health Related Quality of Life (HRQoL). Moreover, rhinitis is present in almost 80% of asthmatics and impacts asthma control and patient HRQoL. We explored whether optimal HRQoL was reachable in a real-life setting, and evaluated the disease and patient related patterns associated to optimal HRQoL achievement.
Asthma and rhinitis HRQoL, illness perception, mood profiles, rhinitis symptoms and asthma control were assessed by means of validated tools in patients classified according to GINA and ARIA guidelines. Optimal HRQoL, identified by a Rhinasthma Global Summary (GS) score ≤20 (score ranging from 0 to 100, where 100 represents the worst possible HRQoL), was reached by 78/209 (37.32%). With the exception of age, no associations were found between clinical and demographic characteristics and optimal HRQoL achievement. Patients reaching an optimal HRQoL differed in disease perception and mood compared to those not reaching an optimal HRQoL. Asthma control was significantly associated with optimal HRQoL (χ(2) = 49.599; p<0.001) and well-controlled and totally controlled patients significantly differed in achieving optimal HRQoL (χ(2) = 7.617; p<0.006).
Approximately one third of the patients in our survey were found to have an optimal HRQoL. While unsatisfactory disease control was the primary reason why the remainder failed to attain optimal HRQoL, it is clear that illness perception and mood also played parts. Therefore, therapeutic plans should be directed not only toward achieving the best possible clinical control of asthma and comorbid rhinitis, but also to incorporating individualized elements according to patient-related characteristics.
哮喘试验表明，达到全面疾病控制的患者具有最佳的健康相关生活质量（HRQoL）。此外，近 80%的哮喘患者存在鼻炎，并影响哮喘控制和患者 HRQoL。我们探讨了在现实环境中是否可以达到最佳 HRQoL，并评估了与实现最佳 HRQoL相关的疾病和患者相关模式。
通过使用经过验证的工具，根据 GINA 和 ARIA 指南对患者进行分类，评估哮喘和鼻炎的 HRQoL、疾病认知、情绪特征、鼻炎症状和哮喘控制情况。最佳 HRQoL 通过 Rhinasthma 全球摘要（GS）评分≤20（评分范围为 0 至 100，其中 100 表示最差的 HRQoL）来确定，209 名患者中有 78 名（37.32%）达到了最佳 HRQoL。除了年龄之外，临床和人口统计学特征与达到最佳 HRQoL之间没有关联。与未达到最佳 HRQoL的患者相比，达到最佳 HRQoL的患者在疾病认知和情绪方面存在差异。哮喘控制与最佳 HRQoL显著相关（χ(2) = 49.599；p<0.001），并且控制良好和完全控制的患者在达到最佳 HRQoL方面存在显著差异（χ(2) = 7.617；p<0.006）。
我们调查中的大约三分之一的患者被发现具有最佳的 HRQoL。虽然不理想的疾病控制是其余患者未能达到最佳 HRQoL的主要原因，但很明显，疾病认知和情绪也起到了一定的作用。因此，治疗计划不仅应针对尽可能实现哮喘和并存鼻炎的最佳临床控制，还应根据患者相关特征纳入个体化元素。
