scholarly journals Asthma control is associated with economic outcomes, work productivity and health-related quality of life in patients with asthma

2020 ◽  
Vol 7 (1) ◽  
pp. e000534
Author(s):  
Lulu K Lee ◽  
Karthik Ramakrishnan ◽  
Guilherme Safioti ◽  
Rinat Ariely ◽  
Michael Schatz

BackgroundThe objective of this analysis was to examine the association between asthma control (based on Asthma Control Test (ACT) responses) and healthcare resource utilisation (HRU), work productivity and health-related quality of life (HRQoL) among a nationwide sample of US adults with a self-reported diagnosis of asthma and without comorbid chronic obstructive pulmonary disease.MethodsData were obtained from the 2015 and 2016 self-administered, internet-based National Health and Wellness Surveys. Patients were grouped by ACT score (≤15: poorly controlled; 16–19: partly controlled; 20–25: well-controlled asthma). Study outcomes included HRU (patient-reported healthcare provider visits, emergency department visits and hospitalisations during the previous 6 months); work productivity, measured using the Work Productivity and Activity Impairment-General Health Scale; HRU-associated costs and work productivity loss and HRQoL, measured using EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) and the Short Form Health Survey-36V.2 (SF-36V.2). Incremental differences in outcomes between groups were assessed using generalised linear models adjusted for covariates.ResultsOf 7820 eligible adults, 17.4% had poorly controlled, 20.1% partly controlled and 62.5% well-controlled asthma. Well-controlled asthma was associated with significantly lower HRU (p<0.001) and lower mean direct costs ($6012 vs $8554 and $15 262, respectively; p<0.001); well-controlled asthma was also associated with significantly lower mean scores for work absenteeism, work presenteeism, overall work impairment and activity impairment (all p<0.001), and lower mean indirect costs ($6353 vs $10 448 and $14 764, respectively; p<0.001). Clinically meaningful differences favouring well-controlled asthma were seen for all HRQoL measures, with statistically significantly higher adjusted mean EQ-5D-5L index and SF-6D Health Utilities Index scores (derived from SF-36V.2) for patients with well-controlled asthma compared with partly controlled or poorly controlled asthma (p<0.001).ConclusionsThe study demonstrates a clear relationship between asthma control and its impact on HRU, costs, work productivity and HRQoL. This will allow for better identification and management of patients with poorly controlled asthma.

2017 ◽  
Vol 2 (4) ◽  
pp. 106-112 ◽  
Author(s):  
April W. Armstrong ◽  
Emily Edson-Heredia ◽  
Baojin Zhu ◽  
Enkeleida Nikaï ◽  
Orin Goldblum ◽  
...  

Background A significant gap exists in how psoriasis severity is related to validated patient-reported outcomes (PROs), which are critical in characterizing disease burden. Objective Determine the association between psoriasis severity and PROs, including health-related quality of life (HRQoL), depression, and work productivity, from patients’ perspectives. Methods An online survey using validated PRO instruments was administered in 2013. PROs included the Dermatology Life Quality Index, Quick Inventory of Depressive Symptoms-Self-Report (16 items) (QIDS-SR16), and Work Productivity and Activity Impairment Questionnaire-Psoriasis. Results The survey was completed by 1109 patients, 42% of whom had psoriatic arthritis. Respondents reported worse HRQoL and work productivity impairment with greater psoriasis severity ( p < 0.05). Similarly, there was a greater proportion of participants with moderate-or-greater depressive symptoms (QIDS-SR16 total score) among patients with increasing psoriasis severity ( p < 0.05). Conclusion Greater levels of impairment in HRQoL, work productivity, and depressive symptoms were associated with increased psoriasis severity.


Author(s):  
Livia Dainelli ◽  
Dan Roberto Luo ◽  
Sarah S. Cohen ◽  
Agnieszka Marczewska ◽  
Jamy D. Ard ◽  
...  

Obesity is highly prevalent and associated with several adverse outcomes including health-related quality-of-life (HRQoL), work productivity, and activity impairment. The objective of this study is to examine group differences in HRQoL and labor-related health outcomes among participants in the OPTIWIN program, which compared the effectiveness of two intensive behavioral weight loss interventions. Participants (n = 273) were randomized to OPTIFAST®(OP) or food-based (FB) dietary interventions for 52 weeks. HRQoL and labor-related health outcomes were measured at baseline, week 26, and week 52, using two questionnaires. At baseline, there were no differences between groups on the Impact of Weight on Quality-of-Life Questionnaire (IWQOL-Lite). At week 26, the OP group had statistically significant differences towards better HRQoL for Physical Function, Self-Esteem, and the total score compared with the FB group. At week 52, the OP group showed better HRQoL in the total score (p = 0.0012) and in all but one domain. Moreover, the adjusted change-from-baseline normalized total score at week 52 was −5.9 points (p = 0.0001). Finally, the mean IWQOL-Lite normalized score showed that HRQoL improves by 0.4442 units (p < 0.0001) per kg lost, and that greater weight reduction was positively associated with better HRQoL. No statistically significant group differences were found with the Work Productivity and Activity Impairment (General Health) (WPAI-GH) Questionnaire. HRQoL improves with highly intensive, well-structured weight loss interventions. Greater weight loss lead to larger improvements. The lack of negative effect on productivity and activity suggests that these interventions may be compatible with an active work lifestyle.


2018 ◽  
Vol 23 (13) ◽  
pp. 1610-1623 ◽  
Author(s):  
Alain Joseph ◽  
Charlotte E. Kosmas ◽  
Chloe Patel ◽  
Helen Doll ◽  
Philip Asherson

Objective: The objective of this study was to assess health-related quality of life (HRQoL) in adult ADHD. Method: U.K. residents aged 18 to 55 years with ADHD and no major mental health comorbidities completed an online survey of disorder history, the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L), and the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH). ADHD Rating Scale-IV (ADHD-RS-IV) score was assessed by telephone. Results: In total, 233 participants completed the study (mean age 32.6 years; 65.2% women). Mean ( SD) ADHD-RS-IV total score, EQ-5D utility, and visual analog scale (VAS) scores were 43.5 (7.88), 0.74 (.21), and 69.8 (17.76), respectively. Mean ( SD) WPAI:GH scores indicated that health problems caused 45.7% (29.9) overall work impairment and 45.8% (28.9) impairment in regular daily activities. Greater work and activity impairment were both significantly independently associated with lower utility after adjusting for age, gender, and somatic comorbidities. Conclusion: Adult ADHD impairs HRQoL, work productivity, and regular daily activities.


2019 ◽  
Vol 8 (8) ◽  
pp. 1171 ◽  
Author(s):  
Satimai Aniwan ◽  
David H. Bruining ◽  
Sang Hyoung Park ◽  
Badr Al-Bawardy ◽  
Sunanda V. Kane ◽  
...  

Background and aims: Patient-reported outcomes (PROs) will become increasingly important as primary endpoints in future clinical trials. We aimed to evaluate the relationship between health-related quality of life (HRQoL) and the combination of patient-reported clinical symptoms (ClinPRO2) and Mayo endoscopic subscore (MES) in patients with ulcerative colitis (UC). Methods: We conducted a prospective cross-sectional study of 90 consecutive UC patients who were scheduled for sigmoidoscopy or colonoscopy. All patients completed the following questionnaires: (1) self-rated rectal bleeding and stool frequency (ClinPRO2); (2) Short Inflammatory Bowel Disease Questionnaire (SIBDQ); (3) European Quality of Life 5-Dimensions 3-Level (EQ5D3L); (4) Work Productivity and Activity Impairment questionnaire (WPAI); (5) Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and (6) Hospital Anxiety and Depression Scale (HADS). The endoscopic images were graded according to the MES. “No symptoms” was defined as a symptom score of 0, and “mucosal healing” was defined as MES score of 0–1. Correlations between the combined ClinPRO2 and MES with HRQoL were assessed using Spearman’s correlation coefficients. Results: The combination of the ClinPRO2 and MES was well correlated to SIBDQ (r = −0.70), EQ5D3L (r = −0.51), WPAI (r = 0.62), FACIT-F (r = −0.58), and HADS-depression (r = 0.45). SIBDQ scores had strong correlations with FACIT-F (r = 0.86), WPAI (r = −0.80), and HADS-depression (r = −0.75) (p < 0.05 for all correlations). Patients with no symptoms reported the greatest all HRQoL scores. Conclusions: In patients with ulcerative colitis, the combination of a ClinPRO2 and the MES had good correlation with the SIBDQ. In addition, SIBDQ was well correlated to the various HRQoL.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S430-S431
Author(s):  
G J Correa ◽  
M Yantorno ◽  
P Olivera Sendra ◽  
J S Lasa ◽  
P Lubrano ◽  
...  

Abstract Background Patient-reported outcomes (PROs) are increasingly recognized as complementary to objective markers of disease activity, yet evidence on PROs in inflammatory bowel disease (IBD) in the real-world setting in Latin America is limited. Herein, we describe health-related quality of life (HRQoL) and work productivity and activity impairment (WPAI) of IBD patients (pts) in Argentina. Methods RISE-AR (NCT03488030) was a non-interventional study with a cross-sectional evaluation and a 3-year retrospective chart review conducted in 7 centres in Argentina (12/2018-05/2019) to assess healthcare resource utilisation, HRQoL and WPAI. Adult pts (≥18 yr old) with a previous diagnosis of moderate-to-severe (Mod/Sev) ulcerative colitis (UC) or Crohn′s disease (CD) based on clinical, endoscopic or imaging criteria ≥6 months prior to enrolment, were included. HRQoL (IBD Questionnaire [IBDQ], 5-dimensional EuroQoL measure [EQ5D]) and WPAI instruments were administered at screening. Disease activity at enrolment was classified as Mod/Sev (Harvey Bradshaw Index ≥8 or partial Mayo Score ≥5) vs. “no-or-mild” (No/Mild). A p-value ≤0.05 was considered statistically significant (Mann-Whitney U test). Results Overall, 246 pts were included (41.1% CD; 58.9% UC). At enrolment, median (range) age (years) was 39.5 (18.2-74.0) for CD (51.2% female) and 41.9 (18.0-80.4) for UC (55.2% female) pts; 20 pts (9.3% CD; 7.7% UC; excluding 4 ostomized pts) had Mod/Sev disease activity. During the previous 3 years, 17.8% (CD) and 1.4% (UC) of pts required ≥1 surgery, and 33.7% (CD) and 21.4% (UC) were hospitalized. No/Mild pts showed significantly higher overall HRQoL scores (mean±SD) vs. Mod/Sev pts in CD (IBDQ: 178.1±35.4 vs. 140.0±43.5, p&lt;0.05; EQ5D [visual analogue scale]: 75.7±1.8 vs. 64.4±5.5, p&lt;0.05) and UC (180.2±32.9 vs. 132.9±43.8, p&lt;0.001; 77.1±1.3 vs. 57.7±5.3, p&lt;0.001), respectively. Activity impairment was reported by 55.4% and 58.6% of CD and UC pts, respectively, while 37.9% and 43.9% of CD and UC employed pts (67 CD, 92 UC; Mod/Sev: 5 CD, 6 UC) reported work impairment. Mod/Sev IBD pts had higher absenteeism (30.8% vs. 6.3%, p&lt;0.05) and presenteeism (20.0% vs. 7.5%, p=0.149) vs. No/Mild pts. Female gender, surgeries and hospitalizations were associated with lower QoL in the overall IBD population. Conclusion This is the first study to evaluate QoL and WPAI in IBD pts in Argentina. Pts with Mod/Sev activity showed impaired QoL and WPAI compared to No/Mild pts. Whilst, less than 10% of IBD pts had Mod/Sev disease activity at enrolment, nearly 60% of the overall IBD population reported either work or activity impairment. Thus, disease activity scores alone may fail to assess the real burden of IBD, suggesting a relevant role for PROs in disease management.


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