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The Impact of Severe Asthma on the Quality of Life: a Systematc Review

      Objectives

      Asthma is one of the most common long term medical conditions and an important contributor to the burden of illness. People with asthma experience poor life satisfaction and require a range of health services to manage their condition. There is a need to assess the instruments by disease concept and interpret the dimension scores. The aim of this systematic review is to assess the impact of severe asthma on the quality of life (QoL).

      Methods

      A systematic search was conducted of the relevant published evidence from Embase and MEDLINE. Search limits were: articles in English, in human and published since year 2005. Retrieved citations were screened by two independent reviewers according to inclusion criteria: severe asthma and baseline QoL data either measured on generic scale or disease-specific scale.

      Results

      A total 29 studies met the inclusion criteria. The majority of studies were observational (14 studies) while seven studies had cross-sectional design. The majority of studies were conducted in adult population (18 studies) while few studies were conducted in children (5 studies). Asthma Quality of Life Questionnaire (AQLQ) was the most frequently used scale among the included studies, assessed in 13 studies followed by St. George’s Respiratory Questionnaire (SGRQ) in six studies. Seven studies reported total AQLQ data with mean scores ranging from 3.1-4.8, which reflect poor QoL. Across these domains, scores assessed on AQLQ - symptoms and AQLQ - activity limitations were lower as compared to AQLQ - emotional function and AQLQ - environmental stimuli. Data also suggested that patients with severe asthma have rapid deterioration in overall health status as compared to patients with mild-moderate asthma.

      Conclusions

      Patients with severe asthma had lower total QoL scores as assessed through different scales, indicating worse QoL. Symptoms and activity limitations are the two main domains that potentially affect the QoL in patients with severe asthma.