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. 2021 Sep 3;11(7):e12054.
doi: 10.1002/clt2.12054. eCollection 2021 Aug.

Predictors of asthma-related quality of life in a large cohort of asthmatics: A cross-sectional study in a secondary care center

Gilles Louis  1 , Benoit Pétré  1 , Florence Schleich  2 , Halehsadat Nekoee Zahraei  3 , Anne-Françoise Donneau  3 , Aude Silvestre  1 , Monique Henket  2 , Virginie Paulus  2 , Françoise Guissard  2 , Michèle Guillaume  1 , Renaud Louis  2
Affiliations

Predictors of asthma-related quality of life in a large cohort of asthmatics: A cross-sectional study in a secondary care center

Gilles Louis et al. Clin Transl Allergy. .

Abstract

Background: In recent decades, asthma-related quality of life questionnaires have joined objective clinical indicators as important outcome measures. In this study, we sought to investigate the predictors of asthma-related quality of life in a large cohort of patients recruited from a secondary care center.

Methods: We conducted a cross-sectional study on asthmatics (N = 1301) recruited from the Liège University Hospital asthma clinic (Belgium). After performing a descriptive analysis highlighting the distribution of scores from the Mini Asthma Quality of Life Questionnaire (Mini AQLQ) and its four dimensions (symptoms, activity limitation, emotional function, and environmental stimuli), we did multiple regression analysis to identify the independent predictors of AQLQ.

Results: Multiple regression beta analysis showed that AQLQ and its four dimensions were primarily associated with asthma control (p < 0.0001 in all instances). Female gender was associated with a lower score for the AQLQ's activity and environmental dimensions (p < 0.05 for both), while current smokers had a higher score on the AQLQ's environmental dimension (p < 0.0001). The burden of asthma treatment was associated with a lower score for the AQLQ's emotional (p < 0.05) and environmental (p < 0.05) dimensions. BMI was associated with a lower score in the AQLQ's activity dimension (p < 0.0001), while the opposite was true for the FeNO test (p < 0.0001). Sputum neutrophils were inversely related to the score for the AQLQ's symptom dimension (p < 0.05), whereas post-bronchodilator FEV1 showed a positive relationship for that same dimension (p < 0.05).

Conclusion: Asthma control is the main predictor of AQLQ score and impacts all its dimensions, but demographic, functional, and airway inflammatory parameters may also influence some dimensions of the AQLQ.

Keywords: Asthme; Contrôle; FeNO; NO exhalé; asthma control; asthma‐related quality of life; qualité de vie liée à l'asthme.

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Conflict of interest statement

Outside of this submitted work, RL received unrestricted research grants from GSK, AstraZeneca, Novartis and Chiesi and lecture or adboard fees from GSK, AZ, Novartis and Sanofi. Outside of this submitted work, FS received lecture or adboard fees from Chiesi, AZ, GSK, and Novartis. The remaining authors declare that they have no relevant conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the patient selection process. ACT, Asthma Control Test; AQLQ, Asthma Quality of Life Questionnaire; PROM, patient‐reported outcome measure
FIGURE 2
FIGURE 2
Distribution of the global AQLQ score and its four dimensions for the entire cohort (N = 1301). AQLQ, Asthma Quality of Life Questionnaire; IQR, interquartile range; SEM, standard error of the mean
FIGURE 3
FIGURE 3
Comparison of the asthma‐related quality of life (AQLQ) activity dimension between patients grouped according to the American Thoracic Society classification for FeNO values (upper panel) and proportion of patients with high AQLQ (AQLQ ≥ 6) in the activity dimension (lower panel). Results are expressed as mean ± standard error of the mean. FeNO < 25 ppb group (N = 698), FeNO 25–50 ppb group (N = 329), and FeNO > 50 ppb group (N = 252) (upper panel)
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