- Email: [email protected]
Associations Between Asthma Control and Health-Related Quality of Life Among Patients With Allergic Asthma on Inhaled Corticosteroids and Long-Acting Beta Agonists Combination Therapy
Allergy and Airway SESSION TITLE: Allergy - Asthma SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
Associations Between Asthma Control and Health-Related Quality of Life Among Patients With Allergic Asthma on Inhaled Corticosteroids and Long-Acting Beta Agonists Combination Therapy Brandee Paknis PharmD* Lulu Lee PhD Engels Obi PhD Abhishek Kavati PhD; and Bradley Chipps MD Novartis Pharmaceuticals Corporation, East Hanover, NJ PURPOSE: To examine level of asthma control and associations with health-related quality of life (HRQoL) among patients with allergic asthma on inhaled corticosteroids (ICS) and long-acting beta agonists (LABA) combination therapy. METHODS: Data from the 2011-2013 US National Health and Wellness Survey, a nationally representative, self-administered, internet-based survey of adults ($18 years old), were used to identify allergic asthma patients currently on ICS and LABA combination therapy (N¼1,923). Allergic asthma was defined by a self-reported physician diagnosis of asthma and at least one of the following allergic comorbid conditions: chronic hives, nasal allergies, hay fever, atopic dermatitis, dermatitis, eczema, or skin allergies. Patients were grouped by asthma control using their scores on the Asthma Control Test (ACT; scores #15: very poorly controlled, 16-19: not well-controlled and 20-25: well-controlled asthma). HRQoL was assessed with the physical component summary score (PCS), mental component summary score (MCS), and SF-6D health utilities derived from the SF-12v2 and SF36v2. Generalized linear models, controlling for covariates (i.e., demographics and health characteristics), examined whether HRQoL differed by asthma control. Adjusted means and p-values were reported from these models.
CONCLUSIONS: Over half (~55%) of all of the allergic asthma patients on ICS and LABA had uncontrolled asthma. Lower levels of asthma control were associated with lower HRQoL among allergic asthma patients treated with ICS and LABA. CLINICAL IMPLICATIONS: The substantial number of uncontrolled allergic asthma patients on ICS and LABA suggests that clinicians may not be following the National Heart, Lung, and Blood Institute’s guidelines to step up therapy. Clinicians should consider stepping up therapy for these patients as findings imply that improving asthma control among allergic asthma patients on ICS and LABA could potentially lead to clinically meaningful improvements on HRQoL. DISCLOSURE: Brandee Paknis: Employee: I am an employee of Novartis Pharmaceuticals Corporation, which funded this study. Lulu Lee: Consultant fee, speaker bureau, advisory committee, etc.: I am an employee of Kantar Health, which received funding from Novartis Pharmaceutical Corporation to conduct this study. Engels Obi: Employee: I am an employee of Novartis Pharmaceuticals Corporation, which funded this study. Abhishek Kavati: Employee: I am an employee of Novartis Pharmaceuticals Corporation, which funded this study. Bradley Chipps: Consultant fee, speaker bureau, advisory committee, etc.: I am a paid consultant of Novartis Pharmaceuticals Corporation, which funded this study. No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.008
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
5A
ALLERGY AND AIRWAY
RESULTS: Patient mean age was 49.8 years (SD¼15.4), 66.3% were female and 75.9% were white. Among all patients, 29.3% (n¼563) had very poorly controlled, 25.1% (n¼482) had not well-controlled, and 45.7% (n¼878) had well-controlled asthma. Very poorly controlled asthma patients relative to not well-controlled and well-controlled asthma patients had lower MCS (adjusted means¼42.59 vs. 45.61 and 48.12), PCS (38.27 vs. 42.73 and 45.14) and health utilities (0.611 vs 0.655 and 0.698), all p<0.001. These differences exceeded minimally important differences (MIDs) of 3 points for MCS and PCS and 0.041 points for health utilities. Not well-controlled patients also had significantly lower MCS, PCS, and health utilities compared with wellcontrolled patients, however only health utilities reach MIDs threshold.
Associations Between Asthma Control and Health-Related Quality of Life Among Patients With Allergic Asthma on Inhaled Corticosteroids and Long-Acting Beta Agonists Combination Therapy Brandee Paknis PharmD* Lulu Lee PhD Engels Obi PhD Abhishek Kavati PhD; and Bradley Chipps MD Novartis Pharmaceuticals Corporation, East Hanover, NJ PURPOSE: To examine level of asthma control and associations with health-related quality of life (HRQoL) among patients with allergic asthma on inhaled corticosteroids (ICS) and long-acting beta agonists (LABA) combination therapy. METHODS: Data from the 2011-2013 US National Health and Wellness Survey, a nationally representative, self-administered, internet-based survey of adults ($18 years old), were used to identify allergic asthma patients currently on ICS and LABA combination therapy (N¼1,923). Allergic asthma was defined by a self-reported physician diagnosis of asthma and at least one of the following allergic comorbid conditions: chronic hives, nasal allergies, hay fever, atopic dermatitis, dermatitis, eczema, or skin allergies. Patients were grouped by asthma control using their scores on the Asthma Control Test (ACT; scores #15: very poorly controlled, 16-19: not well-controlled and 20-25: well-controlled asthma). HRQoL was assessed with the physical component summary score (PCS), mental component summary score (MCS), and SF-6D health utilities derived from the SF-12v2 and SF36v2. Generalized linear models, controlling for covariates (i.e., demographics and health characteristics), examined whether HRQoL differed by asthma control. Adjusted means and p-values were reported from these models.
CONCLUSIONS: Over half (~55%) of all of the allergic asthma patients on ICS and LABA had uncontrolled asthma. Lower levels of asthma control were associated with lower HRQoL among allergic asthma patients treated with ICS and LABA. CLINICAL IMPLICATIONS: The substantial number of uncontrolled allergic asthma patients on ICS and LABA suggests that clinicians may not be following the National Heart, Lung, and Blood Institute’s guidelines to step up therapy. Clinicians should consider stepping up therapy for these patients as findings imply that improving asthma control among allergic asthma patients on ICS and LABA could potentially lead to clinically meaningful improvements on HRQoL. DISCLOSURE: Brandee Paknis: Employee: I am an employee of Novartis Pharmaceuticals Corporation, which funded this study. Lulu Lee: Consultant fee, speaker bureau, advisory committee, etc.: I am an employee of Kantar Health, which received funding from Novartis Pharmaceutical Corporation to conduct this study. Engels Obi: Employee: I am an employee of Novartis Pharmaceuticals Corporation, which funded this study. Abhishek Kavati: Employee: I am an employee of Novartis Pharmaceuticals Corporation, which funded this study. Bradley Chipps: Consultant fee, speaker bureau, advisory committee, etc.: I am a paid consultant of Novartis Pharmaceuticals Corporation, which funded this study. No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.008
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
5A
ALLERGY AND AIRWAY
RESULTS: Patient mean age was 49.8 years (SD¼15.4), 66.3% were female and 75.9% were white. Among all patients, 29.3% (n¼563) had very poorly controlled, 25.1% (n¼482) had not well-controlled, and 45.7% (n¼878) had well-controlled asthma. Very poorly controlled asthma patients relative to not well-controlled and well-controlled asthma patients had lower MCS (adjusted means¼42.59 vs. 45.61 and 48.12), PCS (38.27 vs. 42.73 and 45.14) and health utilities (0.611 vs 0.655 and 0.698), all p<0.001. These differences exceeded minimally important differences (MIDs) of 3 points for MCS and PCS and 0.041 points for health utilities. Not well-controlled patients also had significantly lower MCS, PCS, and health utilities compared with wellcontrolled patients, however only health utilities reach MIDs threshold.