The impact of uncontrolled asthma on quality of life among treated, adherent patients with persistent asthma
Monday, March 5, 2018
South Hall A2 (Convention Center)
Giselle Mosnaim, Lulu K Lee, Colleen Carpinella, Rinat Ariely, Susan Gabriel, Njira L Lugogo
RATIONALE: Few studies have examined unmet needs among treated, adherent asthma patients. This study compared health-related quality of life (HRQoL) between controlled versus uncontrolled treated, adherent patients with persistent asthma.

METHODS: This study used self-reported data from the 2015 and 2016 US National Health and Wellness Survey. Mild, moderate, or severe persistent controlled or uncontrolled, treated, adherent asthma patients were identified. Patients who scored medium/high on the Morisky Medication Adherence Scale (MMAS-8 ©) were classified as adherent. The Asthma Control Test (ACT) identified patients as uncontrolled (scores: ≤19) or controlled (scores: 20-25). HRQoL was assessed using SF-36v2 metrics (i.e., SF-6D health utilities, mental and physical component summary scores [MCS; PCS]) and the EQ5D-5L index score. Generalized linear models examined whether HRQoL outcomes differed by control status.

RESULTS: A majority (73%) of patients had uncontrolled asthma. EQ5D-5L and SF-6D health utilities scores were 0.07 points lower among uncontrolled than controlled patients (EQ5D-5L adjusted means=0.69 vs. 0.76, p<.001; SF-6D adjusted means=0.61 vs. 0.68, p<.001). MCS and PCS scores were significantly lower among uncontrolled than controlled patients (MCS adjusted means=42.72 vs. 47.51, p<.001; PCS adjusted means=39.98 vs. 44.19, p<.001). Minimal important differences were met for all HRQoL outcomes.

CONCLUSIONS: Treated, apparently adherent uncontrolled asthma patients had significantly lower HRQoL (mental and physical) compared with controlled asthma patients. Although assessment of disease severity and medication adherence are important, this study suggests that there are other critical factors in the delivery of care that can improve control and HRQoL.