Abstract
Background: Severe asthma and bronchiectasis are heterogeneous diseases that contribute to disability beyond the pulmonary system. The magnitude of the impact that these extrapulmonary features has on health-related quality of life (HRQoL) is unknown. Methods: We analysed the cross-sectional relationships between HRQoL (St. George's Respiratory Questionnaire; SGRQ) and extrapulmonary characteristics, including physical activity (steps/day), anxiety and depression, isometric leg strength, systemic inflammation, and several comorbidities in adults with severe asthma (n = 70) and bronchiectasis (n = 61). Results: Participants with severe asthma and bronchiectasis had similar SGRQ total scores (mean scores 43.7 and 37.8 for severe asthma and bronchiectasis; p > 0.05), and similar pulmonary and extrapulmonary characteristics. The associations between extrapulmonary variables and HRQoL did not differ according to diagnosis (all interactions p > 0.05). Greater anxiety and depressive symptoms, fewer steps/day and greater systemic inflammation were statistically associated with poorer HRQoL in both diseases (p < 0.05). Lower isometric leg strength in severe asthma, and greater Charlson Comorbidity Index in bronchiectasis were also associated with poorer HRQoL (p < 0.05). In the multivariable regression model performed in the combined disease groups, anxiety and depression, steps/day, systemic inflammation and isometric leg strength remained independently associated with HRQoL. Associations between extrapulmonary characteristics and SGRQ domains were stronger for the activity and impact domains, than symptoms. Conclusion: In severe asthma and bronchiectasis, extrapulmonary features including physical activity and leg strength have a significant impact on HRQoL, especially within the activity and impact domains. These features should be considered as part of the assessment of these conditions, and they may represent additional treatment targets to improve HRQoL.
| Original language | English |
|---|---|
| Pages (from-to) | 93-101 |
| Number of pages | 9 |
| Journal | Respiratory Medicine |
| Volume | 154 |
| DOIs | |
| Publication status | Published - 1 Jul 2019 |
Bibliographical note
Funding Information:This research was supported by a University of Newcastle and Priority Research Centre for Healthy Lungs postgraduate scholarship; a John Hunter Hospital Charitable Trust Grant and the Hunter Medical Research Institute, Australia .
Funding Information:
PGG holds an NHMRC Practitioner Fellowship, has participated in educational symposia funded by AstraZeneca , Boehringer Ingelheim , GlaxoSmithKline and Novartis , and has participated in studies funded by GlaxoSmithKline and AstraZeneca .
Funding Information:
VMM was supported by an NHMRC TRIP fellowship , has participated in educational symposia funded by GlaxoSmithKline , AstraZeneca , Menarini , and Novartis and has participated in advisory boards for GlaxoSmithKline , AstraZeneca and Menarini .
Funding Information:
PAG was supported by a NHMRC-ARC Dementia Research Development Fellowship and has participated in an educational symposium funded by Boehringer Ingelheim .
Funding Information:
This research was supported by a University of Newcastle and Priority Research Centre for Healthy Lungs postgraduate scholarship; a John Hunter Hospital Charitable Trust Grant and the Hunter Medical Research Institute, Australia.PGG holds an NHMRC Practitioner Fellowship, has participated in educational symposia funded by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline and Novartis, and has participated in studies funded by GlaxoSmithKline and AstraZeneca.PAG was supported by a NHMRC-ARC Dementia Research Development Fellowship and has participated in an educational symposium funded by Boehringer Ingelheim.SAH salary has been supported by research grants paid to her institution from GlaxoSmithKline.VMM was supported by an NHMRC TRIP fellowship, has participated in educational symposia funded by GlaxoSmithKline, AstraZeneca, Menarini, and Novartis and has participated in advisory boards for GlaxoSmithKline, AstraZeneca and Menarini. The authors would like to thank participants and their families who made this study possible. They are also grateful to Kelly Steel, Gabrielle Le Brocq, Amber Smith, Penelope Baines, and Michelle Rostas (PRC for Healthy Lungs – University of Newcastle, Australia) for their assistance and technical support with the study visits; and to the laboratory staff from the PRC for Healthy Lungs for conducting the samples analysis.
Publisher Copyright:
© 2019 Elsevier Ltd