title: Impact of asthma control on sleep, attendance at work, normal activities, and disease burden.
abstract: BACKGROUND
  The 2007 Expert Panel Report 3 asthma treatment guidelines place substantial emphasis on understanding the effectiveness of treatment strategies on outcomes such as disease control.
  
  
  OBJECTIVE
  To assess the impact of asthma control on patient-reported outcomes and disease burden in a real-world setting.
  
  
  METHODS
  Patients aged 18 to 64 years with moderate to severe asthma defined by medical and pharmaceutical use were asked to participate in a cross-sectional survey of asthma care, control, and burden. Patients were included if they had an International Classification of Diseases, Ninth Revision, Clinical Modification code for asthma, a prescription for an Expert Panel Report 3-defined controller medication (or combinations), and 24-month pre-index continuous eligibility. Patients with chronic obstructive pulmonary disease were excluded. Survey respondent data were linked to commercial health claims information to create the research database. The Asthma Therapy Assessment Questionnaire (ATAQ) was used as the measure of control. The ATAQ scores range from 0 to 4, with 0 indicating no asthma control problems.
  
  
  RESULTS
  A total of 1,199 patients (73% women) completed the survey and had their claims data linked for analysis. Age, sex, and comorbidity index measures did not differ between respondents and nonrespondents. Only 12.2% of respondents scored 0 on the ATAQ, 77.0% scored 1 or 2, and 10.8% scored 3 or 4. The ATAQ scores were moderately correlated with patient-rated severity. Decreasing levels of asthma control were associated with greater prevalences of sleep problems, depression, functional impairment, and effect on work and regular activities.
  
  
  CONCLUSIONS
  Approximately 88% of patients with moderate to severe asthma were not fully controlled despite anti-inflammatory drug treatment. Lack of asthma control is associated with substantial patient burden.
authors.affiliation: HealthCore Inc, Wilmington, Delaware 19801, USA. dwertz@healthcore.com
authors.forename: Debra A
authors.initials: DA
authors.lastname: Wertz
authors.forename: Michael
authors.initials: M
authors.lastname: Pollack
authors.forename: Keith
authors.initials: K
authors.lastname: Rodgers
authors.forename: Rhonda L
authors.initials: RL
authors.lastname: Bohn
authors.forename: Patricia
authors.initials: P
authors.lastname: Sacco
authors.forename: Sean D
authors.initials: SD
authors.lastname: Sullivan
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012890:Sleep / Q000187:drug effects; D011795:Surveys and Questionnaires; D014481:United States; D014938:Work Capacity Evaluation
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists