Living with asthma
Asthma is a variable disease that can have a significant impact on quality of life for patients. 1-2Its clinical characteristics can differ from person to person and will depend on a number of factors such as comorbidity pattern, triggers and severity level. 3
Severe asthma has a greater impact on patients’ lives than milder forms of the disease. 1A common feature that most severe asthma patients share is that their disease significantly limits their lifestyle. Patients may find themselves unable to participate in certain activities, especially those that are outdoors where they may be exposed to pollution or allergens, or activities that require physical activity. 1-2If asthma is limiting the patients’ ability to work it can also be difficult to keep a job. 2
A limited quality of life
Severe asthma patients can be greatly affected by their condition. These patients – especially those with frequent exacerbations – have significantly reduced health-related quality of life. 1 4They are likely to experience depression, irritability and anxiety, especially when they require OCS therapy. 25
Asthma exacerbations are of sufficient importance that they are used as a measure of disease severity. 36A greater severity and number of asthma exacerbations is significantly associated with decreases in asthma-related quality of life. 5Avoidance of asthma triggers may reduce exacerbation rates and improve asthma-related quality of life in patients with severe or difficult-to-treat asthma. 5
Fear is an emotion that underpins the life of many patients with severe asthma. 2Medication may keep daily symptoms under control, but patients know that there is always the potential for a severe exacerbation. Emotional stress is a strong predictor for an asthma exacerbation; 5likewise, an exacerbation can lead to panic. 2
Living with the side effects of medication can also have an impact on patients’ lives. Some patients require maintenance OCS therapy, which comes with side effects. 7-8For example, broken bones due to the side effect of osteoporosis are a major concern in patients taking OCS. 27-8Obesity and other life-limiting side effects of OCS, such as cataracts and steroid-induced diabetes mellitus, can further restrict activities of patients living with severe asthma. 2
Impact on working life
Severe asthma can present a financial burden to patients, not just from direct (e.g. medication, physician and hospital) costs, but also because it may limit the extent to which they can work (indirect costs). As asthma control decreases, ability to work becomes increasingly impaired. 9Some patients may become so ill that they are unable to work at all. 2
“Even if a patient does not have to take time off work due to their severe asthma, it can still impact productivity. In a study of 2529 patients with asthma, compared with patients with mild or moderate disease, those with severe disease were twice as likely to experience impairment at work (28% vs 14%; p<0.0001), at school (32% vs 18%; p=0.0002) and in daily activities (41% vs 21%; p<0.0001).”
Chen, et al. 2008. 9
- Siroux V, et al. Allergy 2008;63:547–54.
- Hyland ME, et al. Qual Life Res 2015;24:631–9.
- GINA 2016 © 2016 Global Initiative for Asthma, all rights reserved. Use is by express license from the owner. www.ginasthma.org (Last accessed December 2016).
- Lloyd A, et al. Prim Care Respir J 2007;16:22–7.
- Luskin AT, et al. J Allergy Clin Immunol Pract 2014;2:544–52.e2.
- Chung KF, et al. Eur Respir J 2014;43:343–73.
- Walsh LJ, et al. Thorax 2001;56:279–84.
- Walsh LJ, et al. Am J Respir Crit Care Med 2002;166:691–5.
- Chen H, et al. Value Health 2008;11:231–9.