Asthma quality of life in a Southern practice: towards a new paradigm.
BACKGROUND
Quality of life (QOL) surveys are increasingly recognized as part of state-of-the-art asthma assessment. Disease-specific surveys quantitate total QOL and subscale domains which, along with changes in these measures, suggest asthma severity and effects of intervention.


OBJECTIVE
This study was conducted to (1) compare regional variation in QOL and change in QOL in an allergy practice in the South and (2) to examine if one or a set of questions relating to asthma severity could estimate QOL thereby obviating the need for a complete survey.


METHODS
Fifty-eight patients were administered an asthma specific quality of life (AQOL) questionnaire, the Marks et al Asthma Quality of Life survey, at baseline and surveyed in follow-up at 1 and 6 months. Additional questions were asked concerning bronchodilator use in a day and 1 week, missed work/school days, nocturnal wakening in 1 week due to asthma, emergency room visits in the previous month, and past hospitalizations in the last year. Spirometry was performed at each visit.


RESULTS
Baseline AQOL is significantly (P < .05) related individually to nocturnal wakening, bronchodilator use in a day, work or school days missed, and hospitalization during the past year. A model combining these factors explains 49% of the variance, r2 = .49. The AQOL score between baseline and the first month shows a significant improvement (P < .0001) and this improvement is related (P = .002) to the reduction in nocturnal wakenings during that same time period.


CONCLUSIONS
Specialty care intervention affected QOL similarly in the Southern practice compared with other regions/countries. Nocturnal wakening, bronchodilator use in a day, workdays missed, and hospitalization in the past year were all significantly correlated with AQOL. Number of nocturnal wakenings and bronchodilator use in a day may not only stratify asthma severity, they roughly stratify AQOL. The wide scatter of AQOL scores for a given indicator of asthma severity makes a limited combination of questions an indicator but not yet a reliable predictor of AQOL.
Wolf
B L
BL
Vanderbilt University, Nashville, Tennessee, USA.
Reed
G
G
D001249:Asthma / Q000523:psychology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D011331:Private Practice; D011788:Quality of Life; D012720:Severity of Illness Index; D015144:Southeastern United States; D011795:Surveys and Questionnaires
D001993:Bronchodilator Agents