Quality of life in primary care asthma

In primary care, asthma is usually assessed by means of the patients' histo ry regarding symptoms and simple lung-function testing. These outcomes may, however, not be related to other estimates of asthma control such as quali ty of life. In the present study quality of life was studied in relation to symptoms (visual analogue scale, VAS) and lung function in adult patients with asthma in a primary-care setting. In a healthcare centre in Stockholm, 405 individuals diagnosed as having as thma were identified. Out of this number, 120 patients completed the study. Patients were categorized into four groups according to lung function and their response to a question regarding asthma symptoms on the VAS. Quality of life was evaluated with the Asthma Quality of Life Questionnaire (AQLQ) and current treatment was recorded. Quality of life differed significantly between the groups with regard to al l domains and overall score; overall score was 6.0 (0.12-(mean SEM) in grou p A (VAS less than or equal to 2, normal FEV1), 5.4 (0.24) in group B (VAS less than or equal to 2, low FEV1), 4.8 (0.25) in group C (VAS > 2, normal FEV1) and 4.6 (0.24) in group D (VAS > 2, low FEV1) (P < 0.0001). In genera l a gradient, with group A having the highest and group D the lowest score, was detected. Experience of symptoms (VAS >2) was highly related to lower scores in the environmental domain (P < 0.0001). The correlation between FE V1 and quality of life was generally low whereas there was a fairly good co rrelation between VAS and quality of life (P < 0.0001 for all domains). Pat ients without steroid treatment had higher quality of life scores than pati ents treated with steroids. The majority of asthma patients in primary care have high quality of life s cores, indicating a low prevalence of symptoms and only slight activity lim itations. Evaluation of quality of life enables a more careful grading of a sthma status. Furthermore, this measure provides information concerning ast hma control that is not revealed by spirometry and simple questions regardi ng symptoms.