Asthma control is associated with economic outcomes, work productivity and health-related quality of life in patients with asthma

Abstract

BackgroundThe objective of this analysis was to examine the association between asthma control (based on Asthma Control Test (ACT) responses) and healthcare resource utilisation (HRU), work productivity and health-related quality of life (HRQoL) among a nationwide sample of US adults with a self-reported diagnosis of asthma and without comorbid chronic obstructive pulmonary disease.MethodsData were obtained from the 2015 and 2016 self-administered, internet-based National Health and Wellness Surveys. Patients were grouped by ACT score (≤15: poorly controlled; 16–19: partly controlled; 20–25: well-controlled asthma). Study outcomes included HRU (patient-reported healthcare provider visits, emergency department visits and hospitalisations during the previous 6 months); work productivity, measured using the Work Productivity and Activity Impairment-General Health Scale; HRU-associated costs and work productivity loss and HRQoL, measured using EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) and the Short Form Health Survey-36V.2 (SF-36V.2). Incremental differences in outcomes between groups were assessed using generalised linear models adjusted for covariates.ResultsOf 7820 eligible adults, 17.4% had poorly controlled, 20.1% partly controlled and 62.5% well-controlled asthma. Well-controlled asthma was associated with significantly lower HRU (p<0.001) and lower mean direct costs ($6012 vs $8554 and $15 262, respectively; p<0.001); well-controlled asthma was also associated with significantly lower mean scores for work absenteeism, work presenteeism, overall work impairment and activity impairment (all p<0.001), and lower mean indirect costs ($6353 vs $10 448 and $14 764, respectively; p<0.001). Clinically meaningful differences favouring well-controlled asthma were seen for all HRQoL measures, with statistically significantly higher adjusted mean EQ-5D-5L index and SF-6D Health Utilities Index scores (derived from SF-36V.2) for patients with well-controlled asthma compared with partly controlled or poorly controlled asthma (p<0.001).ConclusionsThe study demonstrates a clear relationship between asthma control and its impact on HRU, costs, work productivity and HRQoL. This will allow for better identification and management of patients with poorly controlled asthma.

Integrated Safety and Efficacy Among Patients Receiving Benralizumab for Up to 5 Years

“…[1][2][3][4][5] Because of suboptimal disease management, many with asthma have poor disease control, which is associated with increased risk of exacerbations and hospitalization, reduced health-related quality of life, and increased economic burden. [6][7][8] Approximately 5% to 10% of patients have severe asthma, more than half of whom also have poor disease control. 4,9,10 Estimates suggest that approximately 50% of patients with severe asthma show a T H 2-high phenotype, which is associated with biomarkers including higher blood and sputum eosinophil counts, fractional exhaled nitric oxide values, and IgE levels among others.…”

Temporomandibular disorder–related characteristics and treatment outcomes in Oromandibular Dystonia patients in two different clinical settings: A cross‐sectional study

“…The pooled mean EQ‐5D‐5L of 0.810 (SD 0.19) suggests that these patients have lower health quality than population norms of the United States 28 . This amount of burden experienced by patients with OMD is comparable to the disease burden of people with osteoporosis or dry eye disease, but less burdensome than heart failure, stroke, poorly controlled asthma and pulmonary embolism 29‐34 …”

Breaking the vicious circle—the Asthma Referral Identifier (ReferID) tool

“…Following the recommendation, users have the option to access additional guidelines-based strategies for optimising treatment. The four questions and associated rationale in ReferID are listed in Table 3 2 , 3 , 12 – 14 , 16 , 17 , 35 , 36 . These questions were developed in collaboration with international asthma experts, based on informal feedback from GPs and asthma specialists around the world, in conjunction with GINA recommendations and current peer-reviewed research, the foundations of which are briefly summarised in Table 3 2 .…”

“…These include patients with symptoms or activity limitations despite adherence to preventer medicines, patients who require multiple bursts or long-term OCS, patients who continue to experience exacerbations, and patients who are over-reliant on their SABA, among others 5 , 11 . The burden of disease for patients with severe or uncontrolled asthma is considerable and includes an increased risk of asthma exacerbations, greater asthma-related morbidity, higher healthcare resource utilisation and economic burden, and reduced health-related quality of life 12 – 14 . Systemic corticosteroids (SCS) are frequently used to manage asthma exacerbations and as a result, ~20–60% of patients with severe asthma receive long-term treatment with SCS globally, despite the established risks of increased morbidity and mortality associated with both acute and chronic SCS use 15 – 17 .…”