Impact of Asthma and Comorbid Allergic Rhinitis on Quality of Life and Control in Patients of Italian General Practitioners

Abstract

Objective. Asthma is a disease with elevated prevalence within the general population. Although general practitioners (GPs) are among the first health-care professionals to whom patients refer for their symptoms, there are few evaluations of this disease based on data provided by the GPs. The aim of this observational study is to assess the impact of asthma and comorbid allergic rhinitis on individual/social burden, quality of life, and disease control in asthmatic patients of Italian GPs. Methods. Throughout Italy, 107 GPs enrolled 995 patients diagnosed with asthma and using anti-asthmatic drug prescriptions, or with asthma-like symptoms during the previous 12 months. Data were collected through questionnaires filled out by GPs and patients. Results. Of the 995 asthmatic patients, 60.6% had concomitant allergic rhinitis (R+A), 39.4% had asthma alone. The latter, compared to those with R+A, showed significantly lower prevalence of intermittent asthma (37.5% vs. 55.6%) and higher prevalence of mild, moderate, and severe persistent asthma (28.4% vs. 23.2%, 28.7% vs. 18.8%, and 5.4% vs 2.4%, respectively). Individual/social burden due to asthma was frequent and increased with disease severity: 87.5% of severe persistent asthma patients reported at least one medical consultation in the last 12 months, 37.5% emergency department visits, 26.7% hospitalization, and 62.5% limitations in daily activities. Control and quality of life were inversely associated with disease severity and were worse in patients with R+A than in those with asthma alone. Conclusions. This study showed the negative impact of high severity levels and comorbid allergic rhinitis on quality of life of asthmatic patients and on individual/social burden due to asthma in an Italian GPs setting.

• allergies
• asthma
• primary care
• public health
• quality of life

Acknowledgments

The author would like to thank Alison Frank who checked the manuscript. The authors also thank all the following GPs who actively collaborated in this study:

• Northern Italy:

  • Bergamo: Finazzi Alfredo, Nicoli Sergio, Scorpiniti Anna; Milano: Alexanian Alessandro, Balestracci Lucia, Bonetti Diego, Lo Faro Francesco, Natta Pier Giuseppe, Ravera M. Antonietta; Modena: Andreoli Claudio, Cassanelli Marco, Marazzi Mauro, Reggiani Claudia; Padova: Ciamponi Giuseppina, Ciccolallo Giovanna, Fasolo Luigi, Fioranzato Andreina; Rimini: Della Marchina Maurizio, Di Pasquale Alessandro, Lazzari Agli Antonella, Rinaldi Davide; Sondrio: Boccardi Mauro, Catinella Vincenzo, Glaviano Bruno; Torino: Aires Emiliano, Bornancin Claudio, Dassetto Lorenzo, Musorrofiti Domenico, Piovano Giovanni; Trieste: Pettener Marinella, Vaglieri Gabriella; Udine: Bassi Eliano, Chiarandini Marina, Kussini Khalid, Passoni Laura, Soramel Alberto, Tempo Caterina, Toffoletti Renata, Tubaro Gianni; Varese: Rastelli Emanuela, Tilli G. Mario; Verona: Bonaldi Tiziano, Cressoni Chiara, Galvani Federica, Volpigli Ivan.

• Central Italy:

  • Firenze: Pattarino Eugenio; Lucca: Cecchini Enrico, Martinelli Riccardo, Micheli Luigi, Torre Filippo; Pesaro-Urbino: Masetti Stefano, Ripani Gabriele; Pisa: Barsotti Mauro, Boschi Marcello, Ceccherini Roberto, Cerri Donatella, Gadducci Paola, Lami Tiziano, Monicelli Paolo, Pardini Giuliano, Vancheri Michele; Roma: Berti Roberto, Giannini Pietro, Mangoni Angelo, Scotto Di Fasano Salvatore, Tombesi Eleonora.

• Southern Italy and Islands:

  • Bari: Accettura Vito, De Mola Cosimo, Forte Donata, Ierardi Gianmario, Lacasella Luigi, Lollino Giovanna, Mancini Eugenio, Marzano Giorgio, Martino Michele, Matarrese Vito, Milella Marco, Mirizzi Giuseppe, Scalera Pietro, Sportelli Giovanni; Catania: Calabrese Carlo, Giorgianni Paolo, Iannuzzo Maria, Lombardo Maria, Mocciaro Raffaele, Nicotra Giuseppa Maria, Pagana Giovanni, Panebianco Raffaele, Raciti Teodoro, Toscano Silvia; Napoli: Ciampa Carmelo, Iadicicco Daniele, Stellato Rita, Volpe Augusto; Palermo: Arrigo Nicolò, Bellina Antonio, Scalisi Domenico, Simonetti G. Antonio; Ragusa: Di Giacomo Giovanni, Di Stefano Carmelo Elio; Sassari: Asara Gian Franco, Simula Gianluigi, Spissu Raffaellina; Taranto: Capuzzello Francesco, De Bari Antonio, Leo Arrigo, Urago Marco.

Declaration of Interest

The authors declare that they have no conflicts of interest. This work was supported by the Italian Drug Agency (AIFA) within the Independent Drug Research Program “Respiratory allergic diseases: monitoring study of GINA and ARIA guidelines (ARGA)” [contract No. FARM5JYS5A].