Relationship Between Asthma Control Status and Health-Related Quality of Life in Japan: A Cross-Sectional Mixed-Methods Study

Hiroyuki Nagase; Risako Ito; Moe Ishii; Hideki Shibata; Shintaro Suo; Isao Mukai; Shiyuan Zhang; Kieran J Rothnie; Claire Trennery; Liza Yuanita; Takeo Ishii

doi:10.1007/s12325-023-02660-5

Relationship Between Asthma Control Status and Health-Related Quality of Life in Japan: A Cross-Sectional Mixed-Methods Study

Adv Ther. 2023 Nov;40(11):4857-4876. doi: 10.1007/s12325-023-02660-5. Epub 2023 Sep 12.

Authors

Hiroyuki Nagase¹, Risako Ito², Moe Ishii³, Hideki Shibata³, Shintaro Suo³, Isao Mukai⁴, Shiyuan Zhang⁵, Kieran J Rothnie⁶, Claire Trennery⁶, Liza Yuanita⁴, Takeo Ishii⁷

Affiliations

¹ Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. nagaseh@med.teikyo-u.ac.jp.
² Value Evidence and Outcomes, GSK, 1-8-1 Akasaka, Minato-ku, Tokyo, 107-0052, Japan. risako.2.ito@gsk.com.
³ Mebix, Inc., Minato-ku, Tokyo, Japan.
⁴ Medical Affairs Asthma & COPD, GSK, Minato-ku, Tokyo, Japan.
⁵ Value Evidence and Outcomes, GSK, Collegeville, PA, USA.
⁶ Value Evidence and Outcomes, GSK, Brentford, Middlesex, UK.
⁷ Value Evidence and Outcomes, GSK, 1-8-1 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.

Abstract

Introduction: There is limited information regarding multidimensional relationships between asthma control and health-related quality of life (HRQoL), work productivity, and asthma symptom burden in Japan. Furthermore, systematic qualitative investigations about asthma burden have not been performed.

Methods: This cross-sectional, mixed-methods study included Japanese patients (≥ 20 years) with asthma adherent to inhaled corticosteroids/long-acting β₂-agonists (ICS/LABA). The primary endpoint was impact of asthma on HRQoL, measured using the Asthma Health Questionnaire-33 (AHQ-33). Secondary endpoints were cough burden (Japanese-adapted Leicester Cough Questionnaire [J-LCQ]) and impact of asthma on work/activities (asthma-specific Work Productivity and Activity Impairment Questionnaire [WPAI:Asthma]). Quantitative data were assessed for the overall population and for well-controlled (WC) and not well-controlled (NWC) asthma subgroups. Qualitative verbal interviews further assessed the impact of NWC asthma on patients' HRQoL; emergent themes were extracted using thematic analyses.

Results: Of 454 patients, 45.2% (n = 205) had NWC asthma. Patients with NWC asthma had significantly worse asthma- and cough-related HRQoL across all AHQ-33 and J-LCQ domains and significantly greater work and activity impairment versus patients with WC asthma, across all assessed WPAI:Asthma domains. AHQ-33 total score was highly correlated with J-LCQ total and domain scores (r = - 0.8132 to r = - 0.7407). Nine themes emerged from qualitative interviews and confirmed that patients with NWC asthma had considerable HRQoL impairment due to asthma symptoms.

Conclusions: Patients with NWC asthma had higher symptom burden and worse HRQoL than patients with WC asthma, despite ICS/LABA adherence. Cough burden correlated with HRQoL, suggesting cough may be one of the key markers to inform treatment strategy for patients with asthma.

Keywords: AHQ-33; Asthma; Cough; Disease burden; ICS/LABA; LCQ; Mixed-methods; Qualitative research; Quality of life; WPAI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Administration, Inhalation
Adrenal Cortex Hormones / therapeutic use
Asthma* / drug therapy
Cough / etiology
Cross-Sectional Studies
Drug Therapy, Combination
Humans
Japan
Quality of Life*

Substances

Adrenal Cortex Hormones

Grants and funding

GSK Study 214955/GSK