(P-241) Assessment of Health-related Quality of Life in Adults with Asthma by Asthma Severity

Background: The association between asthma and worsening health-related quality of life (HRQOL) is well-described, but little is known about the HRQOL and patient’s health preference values by the severity of asthma.

Objectives: We evaluated the HRQOL and health utilities of patients with mild, moderate, and severe asthma and identified factors associated with low HRQOL and utilities using nationally representative data in the general U.S. population.

Methods: We conducted a cross-sectional analysis of 2010-2016 Medical Expenditure Panel Survey database to identify asthma patients aged ≥ 18 years and categorized them into three groups by severity (mild, moderate, and severe asthma) based on the Global Initiative for Asthma (GINA) guidelines. Study outcomes included the SF-12 physical and mental component summary (PCS and MCS) for HRQOL and SF-6D for health utility value. SF-6D scores were calculated using the SF-12 PCS and MCS score according to Hanmer’s equation. Survey regression models were used to estimate HRQOL and utility for moderate and severe asthma compared to patients with mild asthma.

Results: Of 10,222 patients with asthma, 75.4%, 23.9%, and 0.8% had mild, moderate and severe asthma. We found that the greater the severity, the lower SF-6D scores with 0.731 in mild, 0.723 in moderate, and 0.659 in severe asthma (P <0.001). Patients with severe asthma had a significantly lower PCS compared to patients with mild asthma (-5.3; P<0.001) but there was no significant difference in MCS (-1.9; P=0.309) after controlling for socioeconomic and clinical variables. Asthma severity, older age, female gender, lower education level, and public insurance were significantly associated with lower PCS (P <0.01).

Conclusions: Patients with severe asthma had substantially lower HRQOL compared to those with mild asthma. Asthma patients had worse physical health than mental health, especially patients with severe asthma. In asthma management plans, providers should be aware of asthma severity as well as physical health of older age, being female, and having low education in order to improve asthma HRQOL.