title: Factors associated with quality of life in patients with severe asthma: the impact of pharmacotherapy.
abstract: OBJECTIVE
  To identify, characterize, and quantify associations of various factors with quality of life (QoL) in patients with asthma, according to the pharmacotherapy employed.
  
  
  METHODS
  This was a cross-sectional study involving 49 patients (≥ 18 years of age) with severe uncontrolled or refractory asthma treated at a specialized outpatient clinic of the Brazilian Unified Health Care System, regularly using high doses of inhaled corticosteroids (ICs) or other medications, and presenting comorbidities. At a single time point, QoL was assessed with the Asthma Quality of Life Questionnaire (AQLQ). The overall AQLQ score and those of its domains were correlated with demographic variables (gender and age); Asthma Control Questionnaire score; pharmacotherapy (initial IC dose, inhaler devices, and polytherapy); and comorbidities.
  
  
  RESULTS
  Better AQLQ scores were associated with asthma control--overall (OR = 0.38; 95% CI: 0.004-0.341; p < 0.001), "symptoms" domain (OR = 0.086; 95% CI: 0.016-0.476; p = 0.001), and "emotional function" domain (OR = 0.086; 95% CI: 0.016-0.476; p = 0.001)-and with IC dose ≤ 800 µg--"activity limitation" domain (OR = 0.249; 95% CI: 0.070-0.885; p = 0.029). Worse AQLQ scores were associated with polytherapy--"activity limitation" domain (OR = 3.651; 95% CI: 1.061-12.561; p = 0.036)-and number of comorbidities ≤ 5--"environmental stimuli" domain (OR = 5.042; 95% CI: 1.316-19.317; p = 0.015).
  
  
  CONCLUSIONS
  Our results, the importance of this issue, and the lack of studies taking pharmacotherapy into consideration warrant longitudinal studies to establish a causal relationship between the identified factors and QoL in asthma patients.
authors.affiliation: Serviço de Farmácia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Daiane Silva
authors.initials: DS
authors.lastname: Souza
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Lúcia de Araújo Costa Beisl
authors.initials: Lde A
authors.lastname: Noblat
authors.affiliation: Serviço de Farmácia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Pablo de Moura
authors.initials: Pde M
authors.lastname: Santos
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology*; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents