Health related quality of life in individuals with asthma related symptoms

Background: Where evidence is required for disease-area prioritisation (e.g. by national policymakers), impact on health related quality of life (HRQoL) can be considered equitably across diseases using quantitative data from generic HRQoL instruments. Before this can take place, it must be shown that the instrument captures HRQoL impairment associated with each disease area. Aim: To ascertain whether the HRQoL impairment associated with respiratory disease can be represented by responses to EQ-5D, a generic HRQoL questionnaire. Method: EQ-5D and a respiratory health questionnaire were sent to 10,471 adults registered with two general practices in Manchester, UK. EQ-5D examines 5 domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and includes an overall rating via visual analogue scale. Societal valuations of domain responses were also considered. Results: HRQoL was substantially reduced in respondents who were likely to have obstructive airways disease (mean EQ-5D(index) 0.63 compared to 0.82, t-test P < 0.001; mean EQ-5D(vas) 62.7 compared to 77.6, t-test P < 0.001) and was negatively associated with respiratory symptoms, older age and female gender. The association with respiratory problems remained following stratification by age and gender. The deficit in HRQoL associated with increasing age was more pronounced in those likely to have obstructive airways disease. Conclusion: HRQoL measured using EQ-5D is substantially reduced in respondents with respiratory symptoms enabling use of the instrument in inter-disease comparisons. (C) 2003 Elsevier Ltd. All rights reserved.