Background In recent decades, asthma‐related quality of life questionnaires have joined objective clinical indicators as important outcome measures. In this study, we sought to investigate the predictors of asthma‐related quality of life in a large cohort of patients recruited from a secondary care center. Methods We conducted a cross‐sectional study on asthmatics ( N = 1301) recruited from the Liège University Hospital asthma clinic (Belgium). After performing a descriptive analysis highlighting the distribution of scores from the Mini Asthma Quality of Life Questionnaire (Mini AQLQ) and its four dimensions (symptoms, activity limitation, emotional function, and environmental stimuli), we did multiple regression analysis to identify the independent predictors of AQLQ. Results Multiple regression beta analysis showed that AQLQ and its four dimensions were primarily associated with asthma control ( p < 0.0001 in all instances). Female gender was associated with a lower score for the AQLQ's activity and environmental dimensions ( p < 0.05 for both), while current smokers had a higher score on the AQLQ's environmental dimension ( p < 0.0001). The burden of asthma treatment was associated with a lower score for the AQLQ's emotional ( p < 0.05) and environmental ( p < 0.05) dimensions. BMI was associated with a lower score in the AQLQ's activity dimension ( p < 0.0001), while the opposite was true for the FeNO test ( p < 0.0001). Sputum neutrophils were inversely related to the score for the AQLQ's symptom dimension ( p < 0.05), whereas post‐bronchodilator FEV 1 showed a positive relationship for that same dimension ( p < 0.05). Conclusion Asthma control is the main predictor of AQLQ score and impacts all its dimensions, but demographic, functional, and airway inflammatory parameters may also influence some dimensions of the AQLQ.

NOVELTY is a prospective real life observational study that investigates asthma, COPD and asthma/ COPD overlap over a period of years with the purpose to relate phenotype and endotype to clinical outcomes and disease trajectories https://bit.ly/3qERZRD

Purpose 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. Methods 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. Results 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). Conclusion 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.

Introduction Recently, the literature has promoted the use of patient‐reported outcome measures (PROMs) in clinical practice as a means to foster patient engagement. However, conditions necessary to support the use of PROMs to encourage asthma patient engagement are not clearly defined. Therefore, we sought (1) to explore the current and ideal use of PROMs by healthcare professionals (HP) in specialized asthma management centers in French‐speaking Belgium and (2) to understand under which conditions the use of PROMs contributes to patient engagement. Methods We undertook a mixed‐methods study with both anonymous online survey and in‐person qualitative semi‐structured interviews conducted with HPs to understand their perspectives on the routine use of PROMs. HPs were recruited from 16 asthma centers (French‐speaking Belgium) identified via the Belgian Respiratory Society. Results Of the 170 HPs identified from the 16 participating centers, 51 (30%) responded to the survey ( n = 51) and 11 completed semi‐structured interviews. 53% (27/51) of the surveyed HPs reported using PROMs primarily for asthma monitoring and clinical research while all reported that PROMs should primarily be used in practice to facilitate communication with the patient and to address neglected aspects of the care relationship such as the psychosocial aspects of the disease. The qualitative interviews revealed avenues for moving from a medical‐centered and utilitarian use of PROMs to a use serving patient engagement. This would require HPs to go beyond their current representation of PROMs, to use instruments offering a more holistic image of the patient, to incorporate PROMs into a digital tool and to integrate PROMs in a patient education process. Conclusion The main findings of this study suggest relevant avenues for using PROMs in ways that support patient engagement.

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