Sullivan Patrick W, Kavati Abhishek, Ghushchyan Vahram H, Lanz Miguel J, Ortiz Benjamin, Maselli Diego J, LeCocq Jason
Department of Pharmacy Practice, Regis University School of Pharmacy, Denver, CO, USA.
US Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
J Asthma. 2020 Nov;57(11):1263-1272. doi: 10.1080/02770903.2019.1645168. Epub 2019 Jul 30.
To estimate the health-related quality of life (HRQoL) and health utilities among asthma patients with and without comorbid allergies in a managed care population. This was a retrospective analysis of patient survey responses and pharmacy claims from the Observational Study of Asthma Control and Outcomes (OSACO). Patients ≥12 years-old with persistent asthma received four identical surveys between April-2011 and December-2012. The presence of allergy was identified by a positive response to a survey question about hay fever/seasonal allergies and ≥1 diagnosis-related ICD-9-CM code(s) for allergic conditions. HRQoL instruments included generic utility (EQ-5D-3L [including VAS]), asthma-specific utility (AQL-5D) and asthma-specific health status (Mini Asthma Quality of Life Questionnaire [MiniAQLQ]). Median regression was used for utility scores and Least Squares regression for MiniAQLQ, adjusting for sociodemographic characteristics and smoking. Of the 2681 asthmatics who completed the first survey in the OSACO study, 971 had comorbid allergies. After adjusting for covariates, asthma patients with comorbid allergies had significantly lower MiniAQLQ scores than patients without allergies (-0.489 [95% CI -0.570, -0.409]; < 0.01), with the greatest decrement/impairment observed for the environmental stimuli domain (-0.729 [95% CI -0.844, -0.613]; < 0.01). Utility scores were also statistically significantly lower for asthma patients with comorbid allergies compared to those without allergies (EQ-5D, -0.031 [95% CI -0.047, -0.015]; AQL-5D, -0.036 [95% CI -0.042, -0.029]; < 0.01 each). The presence of allergies with persistent asthma is associated with a significant deleterious impact on several different measures of HRQoL.
评估管理式医疗人群中合并或未合并过敏症的哮喘患者的健康相关生活质量（HRQoL）和健康效用。这是一项对哮喘控制与结局观察研究（OSACO）中患者调查回复和药房索赔数据的回顾性分析。年龄≥12岁的持续性哮喘患者在2011年4月至2012年12月期间接受了四次相同的调查。通过对关于花粉热/季节性过敏的调查问题的肯定回答以及≥1个与过敏状况相关的诊断性ICD-9-CM编码来确定是否存在过敏。HRQoL工具包括通用效用（EQ-5D-3L[包括VAS]）、哮喘特异性效用（AQL-5D）和哮喘特异性健康状况（迷你哮喘生活质量问卷[MiniAQLQ]）。效用得分采用中位数回归，MiniAQLQ采用最小二乘法回归，并对社会人口学特征和吸烟情况进行了调整。在OSACO研究中完成首次调查的2681名哮喘患者中，971名合并有过敏症。在对协变量进行调整后，合并过敏症的哮喘患者的MiniAQLQ得分显著低于无过敏症的患者（-0.489[95%CI-0.570，-0.409]；P<0.01），其中环境刺激领域的下降/损害最为明显（-0.729[95%CI-0.844，-0.613]；P<0.01）。与无过敏症的哮喘患者相比，合并过敏症的哮喘患者的效用得分在统计学上也显著更低（EQ-5D，-0.031[95%CI-0.047，-0.015]；AQL-5D，-0.036[95%CI-0.042，-0.029]；P均<0.01）。持续性哮喘合并过敏症对HRQoL的几种不同测量指标有显著的有害影响。
