A cross-sectional study to evaluate utility measure and health-related quality of life (HRQoL) among patients with severe uncontrolled asthma in Spain

Abstract

Background and purpose of the study

The utility measure is a method to quantify health-related quality of life according to the preference values that patients attach to their health status. This study aimed to estimate the utility measure of patients with controlled and uncontrolled severe asthma (SA) in Spain, separately. Additionally, other characteristics (sociodemographic, clinical, and healthcare resource use [HCRU]) were also assessed for both SA populations.

Methods

This cross-sectional study included 159 patients with SA in Spain. Data were collected from medical records and directly from the patients during the study visit. Asthma Control Questionnaire (ACQ)-5 was used to classify patients with controlled and uncontrolled SA.

Results

Most of the patients were female (72.0% uncontrolled SA and 63.6% controlled SA). The mean (SD) EuroQol-5D (EQ-5D-5L) score was 0.88 (0.14) and 0.70 (0.25) in controlled and uncontrolled SA, respectively. The mean (SD) Asthma Quality-of-Life-5D (AQL-5D) score was 0.93 (0.09) and 0.85 (0.09) in controlled and uncontrolled SA, respectively. Emergency visits (19.2 vs. 2.7%) and hospitalizations (7.7% vs. no hospitalization) were more common among uncontrolled SA than controlled SA. Mean (SD) number of visits to primary care and pneumologists in uncontrolled SA vs. controlled SA was 4.1 (2.8) vs. 2.5 (3.0) and 3.7 (3.5) vs. 2.8 (2.2), respectively.

Conclusion

The study provides data on utility measures among patients with SA in Spain for the first time. Patients with uncontrolled SA had lower HRQoL and higher HCRU than patients with controlled SA. Therefore, the implementation of measures that improve HRQoL among patients with uncontrolled SA is highly recommended.

KEY POINTS FOR DECISION MAKERS

• Despite the existence in Spain of validated asthma questionnaires, the impact of severe asthma on quality of life, depending on whether it is controlled or not, had never been assessed.

• This study, which included 159 patients, was conducted to fill the gap above by obtaining two utility measures for quality of life, a generic one using the EQ-5D questionnaire (which can be used for comparison with other chronic conditions) and an asthma-specific one using the AQL-5D questionnaire.

• Patients with uncontrolled SA had a lower utility measure than patients with controlled disease and, therefore, a lower quality of life. In addition, patients with uncontrolled SA also had higher use of healthcare resources.

• These results highlight that the implementation of measures that improve the quality of life among patients with uncontrolled SA is highly recommended.

Keywords:

• Severe asthma
• uncontrolled asthma
• utility measure
• health-related QoL
• EQ-5D-5L utility
• AQL-5D utility

Acknowledgments

The authors would like to thank all the researchers for their participation in the study.

Medical writing and other assistance: the realization of this study has been possible thanks to the funding of AstraZeneca and the logistical and technical support (including medical writing) of IQVIA.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Hospital Universitario Dr. Peset, Valencia, Spain.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Author contributions

Sponsorship for this study and article processing charges were funded by AstraZeneca Farmacéutica Spain. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.

All authors have made substantial contributions to ALL of the following:

1. Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work;

2. Drafting the work or revising it critically for important intellectual content;

3. Final approval of the version to be published; and

4. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Declaration of interest

Eva Martínez Moragón reports grants, personal fees and non-financial support from AstraZeneca, personal fees and non-financial support from GSK, personal fees and non-financial support from Novartis, personal fees and non-financial support from Chiesi, personal fees from SANOFI, MSD, FAES, Teva and GEBRO. Dr. Luis M. Entrenas Costa reports grants, personal fees and non-financial support from AMGEN, Astra-Zeneca, Bial, Böehringer-Ingelheim, Chiesi, Faes, Ferrer, Gebro, GSK, Menarini, Novartis, Pfizer, Rovi, Sanofi y Teva Joaquín Sánchez-Covisa Hernández and Gema Monteagudo Ruiz are AstraZeneca employees. Anna de Prado Moncusí reports no conflict of interest.

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available due to all information related to the study is considered confidential until publication but are available from the corresponding author on reasonable request.

Additional information

Funding

Sponsorship for this study and article processing charges were funded by AstraZeneca Farmacéutica Spain. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.