Coexistent Chronic Conditions and Asthma Quality of Life: A Population-Based Study

doi:10.1378/chest.129.2.285

Chest

Volume 129, Issue 2, February 2006, Pages 285-291

https://doi.org/10.1378/chest.129.2.285 Get rights and content

Objective

Reports of the prevalence and impact of comorbid conditions among people with asthma have been limited to certain population groups or convenience samples. Our aim was to examine the prevalence of major comorbidity in asthma and associations with quality of life and functional status in the general population.

Study design/setting

The WANTS Health and Well-being Survey is a cross-sectional representative population household telephone interview survey in three Australian states.

Participants

Representative sample of noninstitutionalized adults in three Australian states.

Measurement and results

From the available sample of 10,080 patients, 7,619 interviews were completed (participation rate, 74.8%), with 834 people reporting current doctor-diagnosed asthma (11.2%). People with asthma were more likely to report one of the selected comorbid conditions: diabetes, arthritis, heart disease, stroke, cancer, osteoporosis (adjusted odds ratio, 1.9; 95% confidence interval, 1.5 to 2.2). Among people with asthma, there were statistically and clinically significant decreases in usual activity levels and in Short Form-12 physical component summary scores when another chronic condition was also present. For those with any of the chronic conditions, the additional presence of asthma was associated with significant further impairment in quality of life in those aged > 35 years but not in younger adults.

Conclusion

The significant reduction in quality of life associated with comorbidity in asthma has implications for disease management and organization of care, as well as for the design and external validity of single-disease clinical trials.

Section snippets

Study Population

All households in the three jurisdictions with a telephone connected and the number listed in the current version of the electronic white pages were eligible for selection in the sample. Samples were drawn separately for each state. The target number of interviews for each state was 2,500. A stratified sampling technique was used with the distribution of these interviews planned: n = 900 in the metropolitan area, n = 800 in rural areas, and n = 800 in remote areas. The minimum sample size of

Results

From the available sample of 10,080, 7,619 interviews were completed (participation rate, 74.8%), with 834 people reporting current doctor-diagnosed asthma (11.2%). The demographic characteristics of people with and without asthma are shown in Table 1. People with asthma were significantly more likely to also report other chronic conditions. Table 2 shows odds ratios from logistic regression analysis for the association between asthma and individual chronic conditions, adjusted for age and

Discussion

In a large population-based sample, we found that selected major chronic conditions occur more frequently in people with asthma, particularly in older age groups. The coexistence of these conditions is associated with greater functional impairment in terms of activity limitation and quality of life than if they are found alone. Again, the effect was seen more clearly in older age groups. Although arthritis was the most common comorbid condition with asthma, the greatest decrements in quality of

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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Funding was provided by the Commonwealth of Australia Department of Health and Aged Care; Department of Human Services South Australia; Department of Health Western Australia; and Northern Territory Department of Health.

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Chest

Original ResearchCoexistent Chronic Conditions and Asthma Quality of Life: A Population-Based Study

Objective

Study design/setting

Participants

Measurement and results

Conclusion

Section snippets

Study Population

Results

Discussion

Respir Med

Chest

Respir Me

Clin Ther

J Allergy Clin Immunol

J Clin Epidemiol

Aust N Z J Public Health

First results Australia

Boston Consulting Group

Report on the cost of asthma in Australia

Characteristics of comorbidity in adult asthma

Public Health Rev

Asthma in older patients: factors associated with hospitalization

Arch Intern Med

Preventable hospitalization among elderly Medicare beneficiaries with type 2 diabetes

Diabetes Care

Long-acting [beta]2-agonist monotherapy vs continued therapy with inhaled corticosteroids in patients with persistent asthma: a randomized controlled trial

JAMA

Original Research
Coexistent Chronic Conditions and Asthma Quality of Life: A Population-Based Study