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. 2024 May 27;10(3):00864-2023.
doi: 10.1183/23120541.00864-2023. eCollection 2024 May.

The illness burden of severe asthma contrasted to people with mild-to-moderate asthma: a qualitative study

Eleanor C Majellano  1   2   3 , Janelle Yorke  4   5 , Vanessa L Clark  1   2   3 , Peter G Gibson  1   2   6 , Amber J Smith  1   2   3 , Leanne J Holmes  7 , Vanessa M McDonald  1   2   3   6
Affiliations

The illness burden of severe asthma contrasted to people with mild-to-moderate asthma: a qualitative study

Eleanor C Majellano et al. ERJ Open Res. .

Abstract

Background: Disabling symptoms of asthma including breathlessness, cough, wheeze and chest tightness largely impact quality of life; however, how these symptoms impact people with asthma of different severity levels remains unknown. This study aimed to compare and characterise patients' symptom experience and the burden caused, their quality of life, and the medication preferences of people with severe asthma against those of people with mild-to-moderate asthma.

Methods: This was a multisite qualitative study involving two focus groups and semistructured interviews of adults with severe asthma undertaken in Australia and UK. Interviews were also undertaken in people with mild-to-moderate asthma. Audio recordings were transcribed and analysed thematically.

Results: Participants in both severe asthma and mild-to-moderate asthma groups had a mean±sd age of 57±12 years. Between the severe asthma and mild-to-moderate asthma groups, 62% of participants were female and 86% lived with family. Themes were identified: 1) what is asthma and most bothersome symptoms: both groups reported breathlessness as the most bothersome symptom; 2) impacts on life: disease-related impact differed as people with severe asthma reported significant burden in their quality of life, which encompassed emotional, physical, social and financial wellbeing; and 3) personalised and responsive care: severe asthma interviewees preferred injectable biological therapy as a mode of treatment administration.

Conclusions: People with asthma are burdened by breathlessness and cough and other disabling symptoms resulting in impaired quality of life. Understanding the experiences of people with asthma of different severities can improve the patient-clinician partnership.

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Conflict of interest statement

Conflict of interest: E.C. Majellano has nothing to disclose. Conflict of interest: J. Yorke has nothing to disclose. Conflict of interest: V.L. Clark has nothing to disclose. Conflict of interest: P.G. Gibson reports grants from GlaxoSmithKline, and personal fees from AstraZeneca, Novartis and GlaxoSmithKline, outside the submitted work. Conflict of interest: A.J. Smith has nothing to disclose. Conflict of interest: L.J. Holmes reports personal fees from TEVA, GSK, AstraZeneca and Novartis, outside the submitted work. Conflict of interest: V.M. McDonald reports grants from the National Health and Medical Research Council during the conduct of the study; grants from the Hunter Medical Research Institute, the National Health and Medical Research Council, Ramaciotti Foundation and the John Hunter Hospital Charitable Trust Research, and grants and personal fees from GlaxoSmithKline and AstraZeneca, outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Modified multisite qualitative analysis approach.
FIGURE 2
FIGURE 2
a) Comparison of the most frequent bothersome symptoms between severe asthma and mild-to-moderate asthma groups. b) Proportion of preferred medication routes of administration between severe asthma and mild-to-moderate asthma groups (Australia participants only). As participants can state more than one preference, the proportions do not all add up to their respective denominations.
See this image and copyright information in PMC

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References

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