Impact of comorbid pathology on the quality of life of patients with bronchial asthma

Abstract

Aim. To study the impact of comorbidities on health-related quality of life (QoL) in patients with asthma, and their interaction with disease control.Materials and methods. We interviewed and examined 360 patients with mild-to-moderate asthma, aged 18 to 62 years, who received standard basic therapy. The examined patients were divided into 2 groups: without concomitant diseases (n=193) and with comorbid conditions (n=167). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined by the ACT questionnaire. The lung function was assessed by means of spirometryResults. Chronic rhinosinusitis, atopic conditions, obesity or overweight, gastroesophageal reflux disease, diseases of the hormonal system were noted among the most frequent comorbidities. Out of 167 asthma patients with comorbidities, 107 had one, and 60 had two or more comorbid conditions. Analysis of the overall QoL according to the SF-36 questionnaire showed a decrease in physical activity in patients with comorbidities. When analyzing specific QoL according to the AQLQ questionnaire, a significant difference was found in the “Activity” domain, the level of which was lower in the group of patients with comorbidity. Calculation of the odds ratio (OR) showed that the presence of comorbid conditions in a patient with asthma increases the likelihood of a decrease in QoL in the domain of physical activity by 2.7 times, and in the presence of two or more concomitant diseases – by 8.4 times.Conclusion. The presence of comorbid pathology reduces the physical functioning and general activity of patients with asthma. The chances of a decrease in QoL in the domain of physical activity increase many times in the presence of two or more comorbid conditions. The addition of concomitant diseases eliminates the influence of the emotional state and, in particular, anxiety, on general health, vitality, and the role of physical problems in limiting the life of asthma patients.