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Health-related quality of life predicts onset of asthma in a longitudinal population study.
Uppsala universitet, Arbets- och miljömedicin) (Arbets- och miljömedicin.
Ersta Sköndal University College, Department of Health Care Sciences.
Uppsala universitet, Lungmedicin och allergologi) (Lungmedicin och allergologi.
Uppsala universitet, Arbets- och miljömedicin) (Arbets- och miljömedicin.
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2009 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 103, no 2, 194-200 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Health-related quality of life (HRQL) has been increasingly used as an outcome measure in asthma, but less is known about the prognostic implication of low health-related quality of life. The purpose of this study was to investigate if a set of quality of life measures could predict onset of asthma. METHODS: In the baseline study 391 subjects without asthma answered a respiratory questionnaire and the Gothenburg Quality of Life (GQL) instrument in 1990. The GQL questionnaire included two parts: (1) the prevalence of HRQL-related symptoms and (2) well-being scores for physical, mental and social dimensions. The participants were also investigated with spirometry and allergy testing. In 2003, the same respiratory questionnaire that had been used in 1990 was sent. There were 290 responders, of whom 22 subjects had developed asthma. RESULTS: Participants who had developed asthma by the follow-up had a higher prevalence of sleep disturbances (30% vs. 10%), problems with chest pain (16% vs. 2%), depression (40% vs. 20%) difficulty relaxing (40% vs. 13%) and constipation (25% vs. 2%) at baseline than participants who did not develop asthma (p<0.05). Subjects who developed asthma also scored significantly lower on well-being variables as sleep, energy, mood, patience, memory, appetite, fitness and sense of appreciation outside home. These differences remained after adjusting for age, sex, smoking habits, asthma heredity, socioeconomic groups and building dampness. CONCLUSION: Participants with low health-related quality of life at baseline were more likely to report having developed asthma 12 years later.

Place, publisher, year, edition, pages
2009. Vol. 103, no 2, 194-200 p.
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:esh:diva-107DOI: 10.1016/j.rmed.2008.09.015PubMedID: 19046862OAI: oai:DiVA.org:esh-107DiVA: diva2:319066
Available from: 2010-05-12 Created: 2010-05-12 Last updated: 2011-04-06Bibliographically approved
In thesis
1. Health-Related Quality of Life in Asthma
Open this publication in new window or tab >>Health-Related Quality of Life in Asthma
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

 

Health-related quality of life (HRQL) has become an important outcome in asthma, since traditional outcomes, such as respiratory symptoms and pulmonary function, might not entirely express the patient’s perception of the limitations caused by the disease. The aim of this thesis was to study HRQL in asthma and to analyse if HRQL was related to asthma onset and prognosis. Other aims were to identify determinants of low HRQL in clinically-verified asthmatics, and to study whether low HRQL was a predictor of mortality.

In 1990, a self-administered questionnaire was completed by 12,560 individuals from three age groups (16, 30-39, and 60-69 years) in two counties of Sweden. In a second phase, all subjects who reported a history of obstructive respiratory symptoms (n = 1,851) and 600 randomly-selected controls were invited to a clinical investigation including spirometry, allergy testing, and assessment of HRQL with the Gothenburg Quality of Life instrument. In 2003, the eligible subjects in the cohort (n=11,282) were sent a new questionnaire. Mortality data in the cohort was followed up during 1990–2008 using data from the National Board of Health and Welfare Mortality Database.

The 616 subjects with clinically-verified asthma 1990 had significantly lower HRQL than subjects without asthma. In the 2003 follow-up, the 305 subjects with persistent asthma had a lower HRQL than the 155 subjects who showed improvement in asthma during the follow-up. Subjects who had developed asthma by the follow-up had a significantly lower HRQL at baseline than those who did not develop asthma. Significant determinants of quality of life in asthma were female sex, smoking habits, higher airway responsiveness to irritants, respiratory symptom severity, positive skin prick test, and absenteeism from work or school. Low HRQL was related to increased mortality, but this association was not found when analyzing the asthmatic group alone.

In conclusion, measurements of HRQL are of value for evaluating both the impact and progression of asthma.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 71 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 584
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-737 (URN)978-91-554-7864-3 (ISBN)
Public defence
2010-10-02, Hörsalen, Akademiska sjukhuset, Dag Hammarskjölds väg 17, Uppsala, 09:15 (Swedish)
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Supervisors
Available from: 2010-10-25 Created: 2010-10-25 Last updated: 2011-05-16Bibliographically approved

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