Quality of Life Research

, Volume 24, Issue 10, pp 2507–2517

The added effect of comorbidity on health-related quality of life in patients with asthma

  • Wenjia Chen
  • Larry D. Lynd
  • J. Mark FitzGerald
  • Carlo A. Marra
  • Roxanne Rousseau
  • Mohsen Sadatsafavi
Article

DOI: 10.1007/s11136-015-0995-6

Cite this article as:
Chen, W., Lynd, L.D., FitzGerald, J.M. et al. Qual Life Res (2015) 24: 2507. doi:10.1007/s11136-015-0995-6

Abstract

Purpose

To examine the effect of comorbidities on health-related quality of life (HRQoL) and their interaction with asthma control.

Methods

In a random sample of adults with asthma, we measured generic (EQ5D) and disease-specific (AQ5D) utility scores. Asthma symptom control was determined using the 2014 Global Initiative for Asthma Management Strategy. Comorbidity scores were calculated using a validated questionnaire. We used two-part regression models to measure the adjusted difference in utility across levels of symptom control and comorbidity scores and to examine the relative role of symptom control and comorbidity in explaining the variation in HRQoL.

Results

A total of 2,299 observations from 460 adult patients (mean age 52 years, 67 % women) were included. Compared to controlled asthma, uncontrolled asthma was associated with −0.018 reduction (95 % CI −0.028, −0.009) in EQ5D and −0.076 reduction (95 % CI −0.115, −0.052) in AQ5D utilities. An increase by one standard deviation in comorbidity score relative to the mean was associated with a change of −0.029 (95 % CI −0.043, −0.016) in EQ5D and −0.010 (95 % CI −0.020, −0.004) in AQLQ utilities. The impact of comorbidity was greater than asthma symptom control in explaining EQ5D variance (12 vs. 1 %) but smaller in explaining AQ5D variance (3 vs. 12 %).

Conclusions

Generic and disease-specific HRQoL instruments differentially capture the impact of symptom control and comorbidity in asthma. The selection of HRQoL instruments for asthma studies should depend on the prevalence of comorbidity in the target population and the impact of interventions on asthma control and comorbidity.

Keywords

Asthma control Comorbidity Health-related quality of life Generic instrument Disease-specific instrument Utility 

Supplementary material

11136_2015_995_MOESM1_ESM.pdf (102 kb)
Supplementary material 1 (PDF 101 kb)

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Wenjia Chen
    • 1
  • Larry D. Lynd
    • 1
    • 4
  • J. Mark FitzGerald
    • 2
    • 3
    • 5
  • Carlo A. Marra
    • 1
    • 4
  • Roxanne Rousseau
    • 2
  • Mohsen Sadatsafavi
    • 2
    • 3
    • 5
  1. 1.Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical SciencesUniversity of British ColumbiaVancouverCanada
  2. 2.Division of Respiratory Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  3. 3.Institute for Heart and Lung HealthUniversity of British ColumbiaVancouverCanada
  4. 4.Centre for Health Evaluation and Outcome SciencesProvidence Health Care Research InstituteVancouverCanada
  5. 5.Centre for Clinical Epidemiology and EvaluationVancouver Coastal Health Research InstituteVancouverCanada

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