Tohda Yuji, Iwanaga Takashi, Sano Hiroyuki, Kume Hiroaki, Hirata Kazuto, Ohkura Noriyuki, Tachibana Isao, Nishimura Yoshihiro, Matsumoto Hisako, Minakata Yoshiaki, Yoshikawa Masanori, Fujimura Masaki
Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Japan.
Department of Respiratory Medicine, Osaka City University Graduate School and Faculty of Medicine, Osaka, Japan.
Int J Clin Pract. 2017 Jan;71(1). doi: 10.1111/ijcp.12898. Epub 2016 Dec 9.
Assessment of the effects of long-term management on patient quality of life (QOL) would be extremely useful for determining asthma treatment strategies. However, no studies have evaluated QOL over an extended period of time. This study evaluated the changes in QOL, drug management and disease severity in the same asthma patients at an interval of approximately 9 years.
We re-surveyed asthma patients enrolled in a survey conducted in 2004 to evaluate the effects of approximately a decade of treatment on disease severity and QOL assessed by the Japanese Asthma Health Questionnaire (AHQ-JAPAN).
A total of 2179 patients were enrolled in the study from 93 centres, and 1332 patients were included in the per-protocol analysis. Usage rates of inhaled corticosteroids (ICS) for treatment of stable asthma were over 90% at both time points. The AHQ-JAPAN total score improved significantly from 22.2±19.7 in 2004 to 19.7±19.9 in 2013 (P<.001). Significant improvements were also observed in 5 of 6 subscales of AHQ-JAPAN, with Social Activity constituting the sole exception.
Asthma severity declined and QOL assessed by AHQ-JAPAN improved, which is considered as a reflection of improved asthma control at least partly attributable to widespread use of anti-inflammatory drugs as represented by ICS. The study also revealed the presence of those with poor QOL, especially in patients with concomitant respiratory diseases, and an increase in severe persistent asthma cases, warranting further long-term efforts at improving QOL.
UMIN 000010483.
评估长期管理对患者生活质量（QOL）的影响对于确定哮喘治疗策略极为有用。然而，尚无研究在较长时间段内评估生活质量。本研究以约9年为间隔，评估了同一组哮喘患者生活质量、药物管理及疾病严重程度的变化。
我们对2004年参与一项调查的哮喘患者进行了重新调查，以评估约十年治疗对疾病严重程度及由日本哮喘健康问卷（AHQ-JAPAN）评估的生活质量的影响。
共有来自93个中心的2179名患者参与了本研究，1332名患者纳入符合方案分析。两个时间点用于稳定期哮喘治疗的吸入性糖皮质激素（ICS）使用率均超过90%。AHQ-JAPAN总分从2004年的22.2±19.7显著改善至2013年的19.7±19.9（P<0.001）。AHQ-JAPAN的6个分量表中有5个也观察到显著改善，社会活动分量表是唯一例外。
哮喘严重程度下降，AHQ-JAPAN评估的生活质量改善，这被认为至少部分反映了哮喘控制的改善，这归因于以ICS为代表的抗炎药物的广泛使用。该研究还揭示了生活质量较差的人群的存在，尤其是在伴有呼吸系统疾病的患者中，以及重度持续性哮喘病例的增加，这需要在改善生活质量方面做出进一步的长期努力。
UMIN 000010483。
