Relationship Between Changes in Quality of Life and Measures of Lung Function and Bronchial Hyper-Responsiveness During
- PDF / 133,429 Bytes
- 6 Pages / 612 x 790.56 pts Page_size
- 84 Downloads / 137 Views
Am J Respir Med 2003; 2 (5): 433-438 1175-6365/03/0005-0433/$30.00/0 © Adis Data Information BV 2003. All rights reserved.
Relationship Between Changes in Quality of Life and Measures of Lung Function and Bronchial Hyper-Responsiveness During High-Dose Inhaled Corticosteroid Treatment in Uncontrolled Asthma Linda C. Orr, Stephen J. Fowler and Brian J. Lipworth Asthma and Allergy Research Group, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, UK
Abstract
Objective: To examine the relationship between changes in quality of life and measures of lung function and bronchial hyper-responsiveness (BHR) during treatment with high-dose inhaled corticosteroids in patients with uncontrolled asthma. Methods: Thirty patients with uncontrolled asthma currently receiving inhaled corticosteroids (median dose 550 μg/day) were treated with beclomethasone dipropionate (BDP) dry powder 2000 μg/day for 4 weeks. Patients completed the Asthma Quality of Life Questionnaire (AQLQ), underwent bronchial challenge with methacholine and spirometry, and made entries in asthma diary cards at baseline and after treatment with beclomethasone dipropionate. Results: The mean change in overall AQLQ score improved significantly (p < 0.05) during the 4-week period by 0.57 (95% CI 0.29–0.84, p < 0.05), representing a minimal important difference, with similar improvements in individual domains. Change in overall AQLQ score correlated significantly with FEV1 (p < 0.001), forced mid-expiratory flow between 25–75% of vital capacity (FEF25–75) [p < 0.05] and morning PEF (p < 0.05), but not with methacholine PD20 i.e. the provocative dose of methacholine causing a 20% fall in FEV1. Conclusions: Quality-of-life scores related to changes in lung function but not BHR during short-term high-dose inhaled corticosteroid therapy for uncontrolled asthma.
Over the past decade, health-related quality of life has gained credence as an outcome measure in both research and clinical practice. A range of health status measures has emerged, each offering different measurement properties and practical features.[1] A number of asthma-specific tools, responsive to small but clinically important changes in health status, have been identified. More recently, attention has focused on interpretation of data generated by these tools and its relationship with more conventional measures of asthma control.[2] The Asthma Quality of Life Questionnaire (AQLQ) is an established tool for assessing healthrelated quality of life, and is widely used as an evaluative and discriminative instrument.[3] It provides a method of quantifying the effects of asthma on patients’ lives.
Conventionally, disease control in the clinic is assessed by symptoms, reliever use, and lung function, and helps determine the effects of disease and benefits of treatment in an individual. Bronchial hyper-responsiveness (BHR) is a fundamental component of asthma, but is not measured routinely in the clinic for assessing control. BHR to methacholine represents an amalgam of pathophysi
Data Loading...
