Adherence to inhaled corticosteroids in relation to quality of life and symptoms of anxiety and depression in asthma
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Adherence to inhaled corticosteroids in relation to quality of life and symptoms of anxiety and depression in asthma. / Renzi-Lomholt, Martino; Håkansson, Kjell Erik Julius; Suppli Ulrik, Charlotte.
In: European Clinical Respiratory Journal, Vol. 10, No. 1, 2149920, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Adherence to inhaled corticosteroids in relation to quality of life and symptoms of anxiety and depression in asthma
AU - Renzi-Lomholt, Martino
AU - Håkansson, Kjell Erik Julius
AU - Suppli Ulrik, Charlotte
N1 - Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Background: Poor asthma control, often caused by non-adherence with controller medication, is a well-known risk factor for impaired quality of life (QoL) and major mood disorders (MMD). Previous studies have shown a relationship between non-adherence, lower QoL, and MMD across chronic diseases, but the relationship remains uncertain in asthma. Methods: All asthma patients followed at the respiratory outpatient clinic at Copenhagen University Hospital–Hvidovre were invited to fill-in the Hospital Anxiety and Depression Scale (HADS) and the Mini Asthma Quality of Life Questionnaire (miniAQLQ). Medication Possession Ratio (MPR) was calculated using pharmacy redemption data. Relationships between questionnaire scores, inhaled corticosteroid MPR and use of rescue medication were investigated using Pearson correlation and multivariable linear regression adjusted for age, sex, FEV1, and GINA Step. Data from scheduled visits were collected from patients’ medical records. Results: A total of 308 patients (73% females, median age 51 years (interquartile range (IQR) 37, 62)) completed the questionnaires and had 1-year medication data available. Median adherence to inhaled corticosteroids (ICS) was 57% (35%, 75%) with 18% of patients having adherence above 80%. Of the participating patients, 14% and 27% reported depressive and anxiety-related symptoms, respectively, and 72% reported impaired QoL. In correlation analyses, ICS adherence was not significantly associated with either prevalence of MMD symptoms or impaired QoL in asthma patients. However, a strong correlation was found between ACQ-6 and both MMD symptoms and impaired QoL, as well as between rescue medication use and impaired QoL. In adjusted analysis, however, the latter correlation was no longer statistically significant. Conclusion: Our results suggest that ICS adherence is not directly correlated with either impaired quality of life or major mood disorder symptoms in asthma patients. Self-reported asthma control, on the other hand, is strongly correlated with both QoL and MMD.
AB - Background: Poor asthma control, often caused by non-adherence with controller medication, is a well-known risk factor for impaired quality of life (QoL) and major mood disorders (MMD). Previous studies have shown a relationship between non-adherence, lower QoL, and MMD across chronic diseases, but the relationship remains uncertain in asthma. Methods: All asthma patients followed at the respiratory outpatient clinic at Copenhagen University Hospital–Hvidovre were invited to fill-in the Hospital Anxiety and Depression Scale (HADS) and the Mini Asthma Quality of Life Questionnaire (miniAQLQ). Medication Possession Ratio (MPR) was calculated using pharmacy redemption data. Relationships between questionnaire scores, inhaled corticosteroid MPR and use of rescue medication were investigated using Pearson correlation and multivariable linear regression adjusted for age, sex, FEV1, and GINA Step. Data from scheduled visits were collected from patients’ medical records. Results: A total of 308 patients (73% females, median age 51 years (interquartile range (IQR) 37, 62)) completed the questionnaires and had 1-year medication data available. Median adherence to inhaled corticosteroids (ICS) was 57% (35%, 75%) with 18% of patients having adherence above 80%. Of the participating patients, 14% and 27% reported depressive and anxiety-related symptoms, respectively, and 72% reported impaired QoL. In correlation analyses, ICS adherence was not significantly associated with either prevalence of MMD symptoms or impaired QoL in asthma patients. However, a strong correlation was found between ACQ-6 and both MMD symptoms and impaired QoL, as well as between rescue medication use and impaired QoL. In adjusted analysis, however, the latter correlation was no longer statistically significant. Conclusion: Our results suggest that ICS adherence is not directly correlated with either impaired quality of life or major mood disorder symptoms in asthma patients. Self-reported asthma control, on the other hand, is strongly correlated with both QoL and MMD.
KW - anxiety
KW - Asthma
KW - depression
KW - inhaled corticosteroids
KW - major mood disorder
U2 - 10.1080/20018525.2022.2149920
DO - 10.1080/20018525.2022.2149920
M3 - Journal article
C2 - 36452910
AN - SCOPUS:85142699983
VL - 10
JO - European Clinical Respiratory Journal
JF - European Clinical Respiratory Journal
SN - 2001-8525
IS - 1
M1 - 2149920
ER -
ID: 334305249