title: Asthma control, quality of life, and the role of patient enablement: a cross-sectional observational study.
abstract: BACKGROUND
  Self-assessment of asthma and a stronger doctor-patient relationship can improve asthma outcomes. Evidence for the influence of patient enablement on quality of life and the control of asthma is lacking.
  
  
  OBJECTIVE
  To assess asthma severity, medication use, asthma control, and patient enablement in patients with asthma treated in primary care and to study the relationship between these variables and quality of life.
  
  
  METHODS
  A cross-sectional study was conducted in an urban clinic in northern Portugal. Data were collected from both clinical records and questionnaires from a random sample of asthma patients. The modified Patient Enablement Instrument, the Asthma Quality of Life Questionnaire, and the Asthma Control Questionnaire were used. Peak expiratory flow and forced expiratory volume in one second (FEV1) were measured. Receiver operating characteristic curve analysis was performed to establish cut-off values for the quality of life measurements. The associations between enablement, asthma control, and quality of life were tested using logistic regression models.
  
  
  RESULTS
  The study sample included 180 patients. There was a strong correlation between asthma control and quality of life (r=0.81, p<0.001). A weak association between patient enablement and asthma control and quality of life was found in the logistic regression models. Poor control of asthma was associated with female gender, concomitant co-morbidities, reduced FEV1, and increased severity of asthma.
  
  
  CONCLUSIONS
  The weak correlation between enablement and asthma control requires further study to determine if improved enablement can improve asthma outcomes independent of gender, severity, and concomitant co-morbidities. This study confirms the strong correlation between asthma control and quality of life.
authors.affiliation: Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga and ICVS-3Bs, PT Government Associate Laboratory, Braga, Guimarães, Portugal. jaimecsousa@gmail.com
authors.forename: Jaime
authors.initials: J
authors.lastname: Correia de Sousa
authors.forename: Alexandra
authors.initials: A
authors.lastname: Pina
authors.forename: Ana Margarida
authors.initials: AM
authors.lastname: Cruz
authors.forename: Ana
authors.initials: A
authors.lastname: Quelhas
authors.forename: Filipa
authors.initials: F
authors.lastname: Almada-Lobo
authors.forename: Joana
authors.initials: J
authors.lastname: Cabrita
authors.forename: Pedro
authors.initials: P
authors.lastname: Oliveira
authors.forename: John
authors.initials: J
authors.lastname: Yaphe
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D011209:Power, Psychological; D011320:Primary Health Care / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D012372:ROC Curve; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents