Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

Abstract

The purpose of this study was to assess the associations between panic disorder (PD) and health services use, health-related quality of life, and use of short-acting β 2 -agonists among individuals with asthma. We studied 21 adults with comorbid asthma and panic disorder (asthma-PD) and 27 asthma patients without PD (asthma-only). Participants attended a single session at a laboratory to complete the study. A retrospective chart review was conducted to assess use of health care resources for asthma treatment during the past 12 months. Patients completed the Asthma Quality of Life Questionnaire and lung function testing. Asthma-only and asthma-PD patients displayed no differences on asthma severity, as measured by spirometry and asthma medication class. Asthma-PD patients had more visits to their primary care physicians for asthma ( p < 0.01) and reported a lower quality of life related to asthma ( p < 0.01) and greater use of short-acting β 2 -agonists ( p < 0.05) than asthma-only patients. These findings were independent of pulmonary function, asthma medication class, and sociodemographic status. These data show that coexistence of PD in asthma is associated with increased use of primary care health resources and greater perceived impairment from asthma, independent of asthma severity. These findings indicate a need to develop interventions to improve quality of life and self-management of asthma among PD patients.

Complex interventions reduce use of urgent healthcare in adults with asthma: Systematic review with meta-regression

“…They carry a negative prognostic value and are associated with worse health outcomes for people with asthma, including: poor medication adherence [11]; poor health-related quality of life [37], increased use of both scheduled and urgent healthcare [12,38,39]. Current NICE guidelines recommend the active treatment of depression in patients with long term conditions, beginning with nonpharmacological approaches but also including antidepressants if indicated [40].…”

Quality of Life in Medically Ill Persons with Comorbid Mental Disorders: A Systematic Review and Meta-Analysis

“…1). Sixty-five primary studies (69 publications) fulfilled inclusion criteria (diabetes: n = 23 [10,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56]; CAD: n = 26 [57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83]; asthma: n = 13 [84,85,86,87,88,89,90,91,92,93,94,95,96,97]; chronic back pain: n = 3 [98,99,100]; colorectal cancer: n = 0). In most cases, depressive disorders were studied (n = 45), followed by anxiety disorders (n = 14), any mental disorder (i.e.…”

Sensory and Affective Aspects of Dyspnea Contribute Differentially to the Borg Scale’s Measurement of Dyspnea

“…In turn, this might lead to an increased use of health care resources to find relieve from the overly negatively perceived symptom. Previous reports have indeed demonstrated that particularly those dyspneic patient groups with a comorbid depression or anxiety disorder show an overuse of β 2 -agonists [28, 29], more visits to their physician [29] and higher rehospitalization rates [30] compared to patients not suffering from these comorbidities. Regression analyses carried out by Main et al [27] have previously underlined this relationship by showing that negative affectivity of asthma patients predicts the use of reliever medications, a relationship which might be mediated by accurate symptom perception.…”

“…This dimension itself might be highly impacted upon by negative affectivity of patients (e.g., depression and anxiety), which is frequent in obstructive pulmonary disorders [21,22,23] and might be associated with inaccurate perception of dyspnea [24,25,26], inadequate use of medication [27, 28], frequent visits to the physician [29] and high rehospitalization rates [30]. However, it is entirely unknown how sensory and affective aspects of dyspnea influence the Borg scale’s measurement of dyspnea, which does not differentiate between these distinct aspects.…”