An Attempted Prospective Testing of an Asthma Severity Index and a Quality of Life Survey for 1 Year in Ambulatory Patients with Asthma

Kucera, Christine M.; Greenberger, Paul A.; Yarnold, Paul R.; Choy, Anita C.; Levenson, Toby

doi:10.2500/108854199778681521

Cited by 11 publications

(5 citation statements)

References 6 publications

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“…For example, in a recent study to develop an asthma severity index (defined as the number and intensity of exacerbations), response to a single global question was the best predictor of asthma severity among a series of items, including respiratory comorbidity, asthma precipitants, spirometry measures, and psychological factors. 26 For our study, the global assessment was used as a measure of current asthma activity, not as a measure of long‐term asthma severity.…”

Section: Methodsmentioning

confidence: 99%

Effects of depressive symptoms on health-related quality of life in asthma patients

2000

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OBJECTIVE:To assess the effects of depressive symptoms on asthma patients' reports of functional status and healthrelated quality of life. DESIGN:Cross-sectional study.SETTING: Primary care internal medicine practice at a tertiary care center in New York City. PATIENTS:We studied 230 outpatients between the ages of 18 and 62 years with moderate asthma. Stepwise multivariate analyses were conducted with the AQLQ and SF-36 scores as the dependent variables and depressive symptoms, comorbidity, asthma, and demographic characteristics as independent variables. The mean age of patients was 41 ؎ SD 11 years and 83% were women. The mean GDS score was 11 ؎ SD 8 (possible range, 0 to 30; higher scores reflect more depressive symptoms), and a large percentage of patients, 45%, scored above the threshold considered positive for depression screening. Compared with patients with a negative screen for depressive symptoms, patients with a positive screen had worse composite AQLQ scores (3.9 ؎ SD 1.3 vs 2.8 ؎ SD 0.8, P Ͻ .0001) and worse PCS scores (40 ؎ SD 11 vs 34 ؎ SD 8, P Ͻ .0001) and worse MCS scores (48 ؎ SD 11 vs 32 ؎ SD 10, P Ͻ .0001) scores. In stepwise analyses, current asthma activity and GDS scores had the greatest effects on patient-reported health-related quality of life, accounting for 36% and 11% of the variance, respectively, for the composite AQLQ, and 11% and 38% of the variance, respectively, for the MCS in multivariate analyses. MEASUREMENTS AND MAIN RESULTS: CONCLUSIONS:Nearly half of asthma patients in this study had a positive screen for depressive symptoms. Asthma patients with more depressive symptoms reported worse healthrelated quality of life than asthma patients with similar disease activity but fewer depressive symptoms. Given the new emphasis on functional status and health-related quality of life measured by disease-specific and general health scales, we conclude that psychological status indicators should also be considered when patient-derived measures are used to assess outcomes in asthma. KEY WORDS

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Section: Methodsmentioning

confidence: 99%

Effects of depressive symptoms on health-related quality of life in asthma patients

2000

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“…Although pulmonary function tests measured during clinical stability may be of some use in predicting outcomes, assessment of lung functions during exacerbations do not have good predictive value for asthma severity or outcomes [23,24]. On the other hand, health services information such as use of airway medications and prior physician/ emergency visits, which indirectly capture severity of disease, correlate well with morbidity and mortality in asthma [25 -27].…”

Section: Discussionmentioning

confidence: 99%

Inhaled corticosteroid therapy reduces the risk of rehospitalization and all-cause mortality in elderly asthmatics

Sin

2001

Eur Respir J

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Inhaled corticosteroid therapy reduces the risk of rehospitalization and all-cause mortality in elderly asthmatics. D.D. Sin, J.V. Tu. #ERS Journals Ltd 2001. ABSTRACT: Elderly patients with asthma have relatively high rates of hospitalization and mortality. Although inhaled corticosteroids have been shown to improve outcomes among younger patients with asthma, their usefulness in elderly patients has not been established. Therefore, a population-based study of patients 65 yrs of age or older, who have been hospitalized at least once with asthma in Ontario, Canada was conducted to determine the impact of inhaled corticosteroids on rehospitalization for asthma and allcause mortality rates.Data from the Canadian Institute of Health Information was used to capture all patients 65 yrs of age and older who were hospitalized at least once, with the most responsible diagnosis of asthma in Ontario, Canada between fiscal year 1992 and 1996. This database was then linked with drug claims, physician billing and mortality databases.In total, 6,254 consecutive elderly patients with asthma were identified. Sixty percent of these patients were given at least one prescription for inhaled corticosteroids within 90 days postdischarge from their index hospitalization for asthma. Users of inhaled corticosteroids postdischarge were 29% (95% confidence interval (CI) 20% -38%) less likely to be readmitted to hospital for asthma and 39% (95% CI, 20% -53%) less likely to experience all-cause mortality compared to those who did not receive these drugs postdischarge over a one year follow-up period.These findings suggest that inhaled corticosteroids are beneficial in reducing the risk for rehospitalization and all-cause mortality in elderly patients with asthma who have recently been hospitalized for their disease.

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“…Also at the level of the individual caretaker is the issue of quality of life. In adults with asthma, poor quality of life has been associated with more severe asthma ratings (Kucera, Greenberger, Yarnold, Choy, & Levenson, 1999). The relationship between asthma control and quality of life is also seen in intervention studies in which asthma management programs have been shown to improve quality of life ratings (de Oliveira, Bruno, Ballini, BritoJardim, & Fernandes, 1997; Lahdensuo et al, 1996) and in studies demonstrating that programs aimed at improving quality of life reduce asthma hospitalizations (Legorreta, Leung, Berkbigler, Evans, & Liu, 2000).…”

Section: Psychological and Social Factors Associated With Asthmamentioning

confidence: 99%

Predictors of repeat hospitalization in children with asthma: The role of psychosocial and socioenvironmental factors.

Chen¹,

Bloomberg²,

Fisher³

et al. 2003

Health Psychology

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This study examined relationships between psychosocial factors and asthma rehospitalization patterns in 115 children (ages 4-18) who had Ն1 hospitalization during the study period. Lifetime history of hospitalizations and new hospitalizations during a 1-year follow-up period were measured, controlling for baseline asthma symptoms and medications. Prospectively, caretaker characteristics (lower sense of mastery, being less emotionally bothered by asthma) predicted greater likelihood of future asthma hospitalizations. Lifetime history of hospitalizations was associated with family impacts (greater family strain and family conflict, greater financial strain) as well as caretaker characteristics (greater personal strain, beliefs about not being able to manage one's child's asthma). These findings could help guide future interventions targeted at the subgroup of children who represent a high proportion of asthma hospitalizations.

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An Attempted Prospective Testing of an Asthma Severity Index and a Quality of Life Survey for 1 Year in Ambulatory Patients with Asthma

Cited by 11 publications

References 6 publications

Effects of depressive symptoms on health-related quality of life in asthma patients

Effects of depressive symptoms on health-related quality of life in asthma patients

Inhaled corticosteroid therapy reduces the risk of rehospitalization and all-cause mortality in elderly asthmatics

Predictors of repeat hospitalization in children with asthma: The role of psychosocial and socioenvironmental factors.

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