Health-Related Quality of Life and Asthma among United States Adolescents

Objective To examine the direction and the magnitude of associations between asthma and health-related quality of life (HRQoL) in a population-based sample of US adolescents. Study design We obtained data from the 2001-2010 cross-sectional National Health and Nutrition Examination Survey. We used multinomial logistic regression and negative binomial regression to estimate corresponding percentages, prevalence ratios (PRs), and predicted days of 4 domains of HRQoL by 3 asthma status categories: never having asthma, having asthma without symptoms, and having asthma with symptoms. Results Compared with those who never had asthma, adolescents with asthma with symptoms of dry cough or wheezing reported significantly worse self-rated health (13.58% [95% CI, 10.32%-17.67%] vs 7.54% [ 95% CI, 6.50%-8.72%] for fair or poor health), significantly impaired physical health (PR = 1.34, P = .004; adjusted physically unhealthy days, 2.7 days vs 2 days), and impaired mental health (PR = 1.26, P = .025). Among adolescents having asthma with symptoms, those who currently smoked reported 1 more physically unhealthy day and 2.4 more mentally unhealthy days than those who did not smoke and did not have asthma. Those reporting limited physical functioning reported 2 more physically unhealthy days and 1.5 more mentally unhealthy days than those who did not report limited functioning. Conclusion Adolescents with asthma and symptoms reported worse HRQoL compared with those with asthma not reporting symptoms and those without asthma. Those who smoked or reported limited physical functioning reported worse physical and mental HRQoL. Reducing symptoms, quitting smoking, and improving physical functioning may improve HRQoL among adolescents with asthma.