The Association Between Asthma Control and Health Care Utilization, Work Productivity Loss and Health-Related Quality of Life

Williams, Setareh A.; Wagner, Samuel; Kannan, Hema; Bolge, S.

doi:10.1097/jom.0b013e3181abb019

Cited by 94 publications

(81 citation statements)

References 21 publications

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“…Poorly controlled asthma places an excess burden in terms of direct healthcare costs as it is associated with increased rates of asthma-related hospitalisations [4,5] we well as emergency department visits [4,5], and use of medications [6,7]. However, the increased consumption of medical resources is not the only factor associated with uncontrolled asthma [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Interaction effect of psychological distress and asthma control on productivity loss?

Moullec

FitzGerald²,

Rousseau³

et al. 2015

Eur Respir J

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Little is known about the potential synergistic effect of comorbid psychological distress (PD) and uncontrolled asthma (UA) on productivity loss. We estimated the productivity loss associated with the combination of these two potentially preventable conditions in employed adults with asthma.A population-based random sample of 300 adults with asthma in British Columbia, Canada, was prospectively recruited between Dec 2010 and Aug 2012. PD and productivity loss due to absenteeism and presenteeism was measured using validated instruments, and asthma control was ascertained using 2010 Global Initiative for Asthma management strategy. We used two-part regression models to study the contribution of UA and PD to productivity loss.Compared with reference group (controlled asthma (CA)+noPD), those with UA+noPD had CAD$286 (95%CI $276-297) weekly productivity loss, and those with CA+PD had CAD$465 ($445-485). Those with UA+PD had CAD$449 (437-462) in productivity loss. There was no significant interaction effect of PD with asthma control levels on productivity loss ( p=0.22).In patients without PD, uncontrolled asthma was associated with a higher productivity loss than controlled asthma, but this was not the case in patients with PD. This finding can be explained by the fact that the contribution of PD to productivity loss is so large that there is no room for synergy with asthma control. Future studies should assess the impact of interventions that modify PD in patients with asthma. @ERSpublications With psychological distress, the further additive effect of asthma control on productivity loss is minimal

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Section: Introductionmentioning

confidence: 99%

Interaction effect of psychological distress and asthma control on productivity loss?

Moullec

FitzGerald²,

Rousseau³

et al. 2015

Eur Respir J

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“…Recent data show that only 23% of asthmatics are controlled [9] and, despite receiving specialist care, 50% are not well controlled [8]. Poor asthma control has been associated with more emergency room visits, physician visits and days spent in hospital [10].…”

mentioning

confidence: 99%

Exercise is associated with improved asthma control in adults

Dogra¹,

Kuk²,

Baker³

et al. 2010

Eur Respir J

108

106

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Global asthma control levels are suboptimal. The influence of regular exercise on asthma control is unclear.We assessed the effects of a 12-week supervised exercise intervention followed by 12 weeks of self-administered exercise on adults with partially controlled asthma (n521) and matched controls (n515). Assessments were conducted at baseline and week 12 for both the exercise and control group, and again at week 24 for the exercise group.There was a significant treatment effect on asthma control in the exercise group, as measured by the Asthma Control Questionnaire (ACQ), from baseline to week 12, compared with the control group. A clinically significant improvement (0.5 increase in ACQ score) was observed for asthma quality of life and ACQ in the exercise group from baseline to week 12. There was a significant improvement in aerobic fitness from baseline to week 24 in the exercise group.In conclusion, a 12-week supervised exercise intervention led to improvements in asthma control and quality of life in partially controlled asthmatics motivated to exercise. These improvements were maintained, while aerobic fitness and perceived asthma control significantly improved over an additional 12 weeks of self-administered exercise. These findings indicate that a structured exercise intervention can improve asthma control.

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“…9,13,25,30 A cutoff score of Յ19 was associated with higher risk of adverse asthma outcomes, such as asthma exacerbation 17,31 and urgent health-care utilization. 17,32 With regard to NAEPP EPR-3 guidelines, a score of Ն20 indicates well-controlled asthma, a score of 16 -19 indicates not well-controlled asthma, and a score of Յ15 indicates very poorly controlled asthma. 13,33 An ACT score of Յ15 predicted future asthma exacerbations in multiple studies.…”

Section: Accuracymentioning

confidence: 99%

Asthma Control Assessment Tools

Alzahrani

Becker

2015

Respir Care

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, and they emphasize periodic assessment of asthma control once treatment is established. Accurate assessment of asthma control is difficult due to the complexity of asthma control and due to the limitations in the traditional methods of assessment, such as lung function tests, physician assessment, and patients' self-assessment. Relying solely on the role of lung function tests is insufficient to reflect the status of asthma control, since patients with asthma may have normal spirometry between exacerbations. Clinicians often overestimate the level of asthma control. Similarly, it is not uncommon for patients to overestimate how well their asthma is controlled, and, therefore, they under-report asthma symptoms and fail to recognize the impact that asthma has on their daily life. As a result, several tools have been developed to quantify the level of asthma control, identify patients at risk, and evaluate the effect of asthma management. This review examines the commonly 106RESPIRATORY CARE • JANUARY 2016 VOL 61 NO 1 used asthma control assessment tools in terms of content, psychometric properties, methods of administration, limitations, and ability to reflect the overall status of asthma control, which can aid clinicians in selecting the most appropriate tool for their needs.

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The Association Between Asthma Control and Health Care Utilization, Work Productivity Loss and Health-Related Quality of Life

Abstract: Results indicate that asthma control is associated with better health outcomes. Management with therapies optimizing asthma control may reduce direct and indirect costs of treatment.

Cited by 94 publications

References 21 publications

Interaction effect of psychological distress and asthma control on productivity loss?

Interaction effect of psychological distress and asthma control on productivity loss?

Exercise is associated with improved asthma control in adults

Asthma Control Assessment Tools

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