Patient-Reported Outcome in Two Chronic Diseases: A Comparison of Quality of Life and Response Profiles in Severe Migraine and Severe Asthma

Abstract

Introduction

Migraine and asthma are two frequent, disabling, chronic disorders with a major impact on patient well-being. The objectives of this study were to compare subjective well-being between patients with severe forms of migraine or asthma using a panel of PROs.

Methods

Adult patients were recruited during routine consultations with chest physicians or neurologists. Patients with severe migraine (reporting headaches on ≥8 days/month and having failed ≥2 prophylactic treatments) and patients with severe asthma (according to the 2017 GINA definition: requiring Step 4 or 5 treatment or presenting uncontrolled symptoms) were eligible. Each patient completed the EuroQol Questionnaire (EQ-5D-5L), the Work Productivity and Activity Impairment Questionnaire (WPAI) and the Hospital Anxiety and Depression scale (HAD). Patients with severe migraine the 6-item Headache Impact Test (HIT-6) and those with severe asthma completed the Asthma Control Test (ACT).

Results

249 patients with severe migraine and 96 with severe asthma were enrolled. Mean EQ-5D-5L utility scores were significantly higher in the severe migraine group than in the severe asthma group (0.75±0.25 vs 0.68±0.26; p<0.01). Low EQ-5D-5L utility scores were associated with frequent (≥15 headache days/month) or disabling (HIT-6 score ≥60) headaches and with poor asthma control. Patients with severe migraine more frequently presented a HAD depression score ≥11 (23.0% in severe migraine; 7.5% in severe asthma; p<0.01), whereas those with severe asthma more frequently reported problems with mobility, self-care and usual activities. Absenteeism (percent worktime missed) was similar in both groups (severe migraine: 9.0%±19.1%; severe asthma: 13.8%±22.9%) but work impairment was higher in the severe migraine group (44.3% vs 28.4%; p<0.01).

Conclusion

Quality of life, work activity and psychological distress are all deteriorated in both severe migraine and severe asthma. Different aspects are affected in the two diseases: a greater impact on psychological aspects in severe migraine and a greater impact on physical aspects in severe asthma.

Keywords:

• quality of life
• work performance
• psychological distress
• asthma
• migraine

Data Sharing Statement

The data are hosted by a third party (Kantar Health). Access to the data will require special permission. Reasonable requests can be made to the corresponding author, who will transfer the request to the database manager.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Dr Christian Lucas reports personal fees from Novartis, during the conduct of the study; personal fees from Lilly, personal fees from Amgen, personal fees from Ethypharm, grants and personal fees from Sanofi, personal fees from Teva, personal fees from Grunenthal, personal fees from Biogen, and personal fees from Boston Scientific, outside the submitted work. Prof. Dr. Gilles Garcia reports personal fees from Novartis, during the conduct of the study; personal fees from GSK, AstraZeneca, Roche, Sanofi, and MSD, outside the submitted work. Mrs Samia Aly is an employee of Novartis. Mrs Chantal Touboul, Mrs Rahma Sellami and Mr Xavier Guillaume are employees of Kantar Health. Mrs Chantal Touboul and Mr Xavier Guillaume report personal fees from Novartis, during the conduct of the study. The authors report no other conflicts of interest in this work.

Additional information

Funding

The study was funded by Novartis.