Health-Related Quality of Life and Asthma among United States Adolescents

Abstract

Objective To examine the direction and the magnitude of associations between asthma and health-related quality of life (HRQoL) in a population-based sample of US adolescents. Study design We obtained data from the 2001–2010 cross-sectional National Health and Nutrition Examination Survey. We used multinomial logistic regression and negative binomial regression to estimate corresponding percentages, prevalence ratios (PRs), and predicted days of 4 domains of HRQoL by 3 asthma status categories: never having asthma, having asthma without symptoms, and having asthma with symptoms. Results Compared with those who never had asthma, adolescents with asthma with symptoms of dry cough or wheezing reported significantly worse self-rated health (13.58% [95% CI, 10.32%–17.67%] vs 7.54% [95% CI, 6.50%–8.72%] for fair or poor health), significantly impaired physical health (PR = 1.34, P = .004; adjusted physically unhealthy days, 2.7 days vs 2 days), and impaired mental health (PR = 1.26, P = .025). Among adolescents having asthma with symptoms, those who currently smoked reported 1 more physically unhealthy day and 2.4 more mentally unhealthy days than those who did not smoke and did not have asthma. Those reporting limited physical functioning reported 2 more physically unhealthy days and 1.5 more mentally unhealthy days than those who did not report limited functioning. Conclusion Adolescents with asthma and symptoms reported worse HRQoL compared with those with asthma not reporting symptoms and those without asthma. Those who smoked or reported limited physical functioning reported worse physical and mental HRQoL. Reducing symptoms, quitting smoking, and improving physical functioning may improve HRQoL among adolescents with asthma.

Barriers and facilitators to self‐management of asthma in adolescents: An interview study to inform development of a novel intervention

“…The impact of asthma on daily life extends beyond the typical symptoms of wheeze, breathlessness, chest tightness and cough. Adolescents with asthma are more likely to have poorer physical and mental health and report lower quality of life compared to their peers without asthma . Furthermore, despite the availability of effective pharmacological treatments, many continue to have poor asthma control, which is often attributed to poor adherence to treatment …”

The Effects of Asthma and Bullying on Suicidal Behaviors Among US Adolescents

“…Earlier reports have presented reasons why having asthma might increase the likelihood of suicidal ideation and/or behaviors. For example, Goodwin and Marusic note that asthma is “associated with impairment in school and social functioning, symptoms of depression, anxiety symptoms, and anxiety disorders” and that “suicidal ideation is among the strongest predictors of suicidal behavior.” Similarly, the results of the 2001‐2010 National Health and Nutrition Examination Survey indicate that US adolescents who were diagnosed with asthma incurred more days of feeling mentally unwell relative to adolescents who were never diagnosed with asthma . Youth with asthma often report feeling stigmatized, and some researchers have noted that even primary school‐aged children with asthma may feel their activities and their social lives are often limited by their condition; being bullied may be one of the consequences of having asthma…”

Adolescent Preferences and Design Recommendations for an Asthma Self-Management App: Mixed-Methods Study (Preprint)

“…[2] Adolescents with asthma who have symptoms report significantly worse self-rated health and both significantly impaired physical and mental health than those without asthma. [3] However, negative health outcomes can be drastically reduced and prevented through proper disease self-management. [4] Leveraging technology in healthcare to support adolescent disease management seems warranted.…”

“…[6][7][8] Although mobile app use is increasing among the adolescent population, only eight out of 147 asthma apps are targeted towards children or young adults. [9] Given that declines in treatment adherence have been observed during adolescence and adolescents with asthma are at increased risk of poor health outcomes when compared with people with asthma of other age groups, [3,10,11] apps targeting this age group are crucial. Furthermore, apps for adolescents should be designed with their specific self-management needs in mind to facilitate engagement.…”