Assessing Productivity Loss and Activity Impairment in Severe or Difficult-to-Treat Asthma

doi:10.1111/j.1524-4733.2007.00229.x

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Wiley InterScience

Value in Health

Volume 11 Issue 2, Pages 231 - 239

Published Online: 17 Jul 2007

Published on behalf of the International Society for Pharmacoeconomics and Outcomes Research

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Assessing Productivity Loss and Activity Impairment in Severe or Difficult-to-Treat Asthma

Hubert Chen, MD, MPH, ^1,2 Paul D. Blanc, MD, MSPH, ¹ Mary L. Hayden, FNP, AE-C, ³ Eugene R. Bleecker, MD, ⁴ Anita Chawla, PhD, ² June H. Lee, MD ² for TENOR Study Group*

¹ Department of Medicine, University of California, San Francisco, CA, USA; ² Genentech, Inc., South San Francisco, CA, USA; ³ School of Nursing, University of Virginia, Charlottesville, VA, USA; ⁴ Wake Forest University, Winston-Salem, NC, USA

Correspondence to Hubert Chen, University of California, San Francisco, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94143-0924, USA. E-mail: hubert.chen@ucsf.edu

*For a complete list of TENOR Study Group members, please contact Genentech, Inc.

KEYWORDS

asthma • impairment • productivity • work

ABSTRACT

Objectives: Asthma can be associated with substantial productivity loss and activity impairment, particularly among those with the most severe disease. We sought to assess the performance characteristics of an asthma-specific adaptation of the Work Productivity and Activity Impairment Questionnaire (WPAI:Asthma) in patients with either severe or difficult-to-treat asthma.

Methods: We analyzed 2529 subjects from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. The WPAI:Asthma was administered at baseline and at 12 months. Asthma control and quality-of-life were simultaneously assessed using the Asthma Therapy Assessment Questionnaire and Mini-Asthma Quality-of-Life Questionnaire, respectively.

Results: Severe versus mild-to-moderate asthma was associated with a greater percentage of impairment at work (28% vs. 14%), at school (32% vs. 18%), and in daily activities (41% vs. 21%). At baseline, greater asthma control problems correlated with higher levels of impairment as measured by the WPAI (work: r = 0.54, school: r = 0.37, activity: r = 0.55). Over the 12-month follow-up period, improved quality-of-life correlated with decreased levels of impairment (work: r = −0.42, school: r = −0.36, activity: r = −0.48). In multivariate analyses, greater than 10% overall work impairment at baseline predicted emergency visits (OR 2.6 [1.6, 4.0]) and hospitalization (OR 4.9 [1.8, 13.1]) at 12 months.

Conclusions: The WPAI:Asthma correlates with other self-reported asthma outcomes in the expected manner and predicts health-care utilization at 12 months when administered to patients with severe or difficult-to-treat asthma.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1524-4733.2007.00229.x About DOI