Department of Public Health, University of Liège, Liège, Belgium.
Department of Pneumology, University of Liège, GIGAI3, Liège, Belgium.
Qual Life Res. 2023 May;32(5):1507-1520. doi: 10.1007/s11136-022-03339-0. Epub 2023 Jan 3.
Asthma negatively impacts health-related quality of life (HRQL). The objective is to investigate the longitudinal relationship between HRQL in asthma and disease control, demographic and clinical objective parameters in an adult population in real-life settings.
We conducted a longitudinal study on adult asthmatics recruited from Liege University Hospital Asthma Clinic (Belgium) between 2011 and 2019. We selected those who had two visits and completed two patient-reported outcome measures (PROMs), the asthma control test (ACT) and the mini asthma quality of life questionnaire (AQLQ) (n = 290). AQLQ was the dependent variable. Demographic, functional and inflammatory characteristics, asthma control, and exacerbations were the independent variables. We applied generalized linear mixed models to identify the factors associated with change in AQLQ and its dimensions.
Median (IQR) time interval between the two visits was 7 (5-19) months. Overall, median (IQR) global AQLQ increased from 4.1 (3-5.1) to 4.6 (3.4-5.9) (p < 0.0001). All AQLQ dimensions significantly improved, apart the environmental one. AQLQ improved in patients who had both step-up and step-down pharmacological treatment as well as in patients reporting no change between the two visits. The fitted models indicated that change in ACT was the main predictor of change in AQLQ (p < 0.0001). A rise in 3 units in ACT predicted an improvement of 0.5 AQLQ (AUC-ROC = 0.85; p < 0.0001). Change in BMI inversely impacted global AQLQ (p < 0.01) and its activity dimension (p < 0.0001).
Asthma control and BMI are key predictors of asthma quality of life acting in an opposite direction. AQLQ may improve without step-up in the pharmacological treatment.
哮喘会对健康相关生活质量（HRQL）产生负面影响。本研究旨在探讨在现实环境中，成人哮喘患者的 HRQL 与疾病控制、人口统计学和临床客观参数之间的纵向关系。
我们进行了一项纵向研究，纳入了 2011 年至 2019 年期间在列日大学医院哮喘诊所（比利时）就诊的成年哮喘患者。我们选择了那些有两次就诊并完成了两项患者报告结局测量（PROMs）的患者，即哮喘控制测试（ACT）和迷你哮喘生活质量问卷（AQLQ）（n=290）。AQLQ 为因变量，人口统计学、功能和炎症特征、哮喘控制和加重为自变量。我们应用广义线性混合模型来确定与 AQLQ 及其维度变化相关的因素。
两次就诊之间的中位（IQR）时间间隔为 7（5-19）个月。总体而言，全球 AQLQ 的中位数（IQR）从 4.1（3-5.1）增加到 4.6（3.4-5.9）（p<0.0001）。除环境维度外，所有 AQLQ 维度均显著改善。在经历药物治疗升级和降级以及两次就诊之间报告无变化的患者中，AQLQ 均得到改善。拟合模型表明，ACT 的变化是 AQLQ 变化的主要预测因素（p<0.0001）。ACT 增加 3 个单位可预测 AQLQ 改善 0.5 分（AUC-ROC=0.85；p<0.0001）。BMI 的变化与全球 AQLQ （p<0.01）及其活动维度（p<0.0001）呈负相关。
哮喘控制和 BMI 是哮喘生活质量的关键预测因素，它们的作用方向相反。在药物治疗未升级的情况下，AQLQ 可能会改善。
