Quality of life in adolescents with mild asthma

Abstract

The majority of individuals with asthma have mild disease, often in conjunction with allergic rhinitis and exercise-induced bronchoconstriction (EIB). Although health-related quality-of-life (HRQoL) is reduced in moderate to severe asthma and allergic rhinitis, little is known about the effect of mild asthma, mild allergic rhinitis, and EIB on HRQoL outcomes. The objective of this study was to determine the effect of mild asthma, allergic rhinitis, and EIB on HRQoL. A cross-sectional study was conducted of 160 adolescent athletes participating in a screening program to detect EIB. Generic HRQoL was assessed with the teen version of the pediatric quality-of-life inventory (PedsQL). Prior diagnoses of asthma, allergic rhinitis, and EIB, and current symptoms of dyspnea during exercise and asthma, were recorded. Lung function and the presence of EIB were determined by spirometry before and after an exercise challenge test. Adolescent athletes with a prior physician diagnosis of asthma had a lower HRQoL scale summary score (P<0.01) and lower physical functioning, emotional functioning, and school functioning domain scores (P values, 0.01-0.02) in comparison to adolescent athletes with no prior diagnosis of these disorders. Athletes with a prior diagnosis of asthma reported dyspnea during exercise more frequently than did those without asthma (P<0.001). Adolescent athletes with dyspnea during exercise had a lower scale summary score, and lower physical functioning, general well-being, and emotional functioning domain scores (P values, 0.02-0.03). These data show that mild asthma and dyspnea without asthma significantly affect HRQoL. Symptoms of dyspnea during exercise are common in asthma and are associated with lower HRQoL. The clinical significance of these differences in HRQoL is unclear.

Fig. 1.

Recruitment of study population from adolescent athletes participating in screening physical examination prior to sports.

Fig. 2.

Comparison of HRQoL domain and summary scores in adolescent athletes with and without prior diagnosis of asthma. Error bars represent standard error of mean.

Fig. 3.

Comparison of HRQoL domain and summary scores in adolescent athletes with and without symptoms of dyspnea during exercise. Error bars represent standard error of mean.

Fig. 4.

Comparison of HRQoL scale summary scores in adolescent athletes with and without prior diagnosis of asthma. Groups were subdivided based on presence or absence of dyspnea during exercise. Mean HRQoL score was significantly lower in group with prior diagnosis of asthma. But in those with asthma, no additional reduction in HRQoL was attributable to symptoms of dyspnea. In group without prior diagnosis of asthma, symptoms of dyspnea during exercise were associated with significantly lower HRQoL. Error bars represent standard error of mean.