Relationships of Asthma Control and Quality-of-Life

During 2008, 1.4% of patients required a hospitalization for asthma; 4.4% required an ED visit because of asthma; 4.7% of patients required either an asthma hospitalization or ED visit; and 23.3% received oral corticosteroids for an asthma exacerbation within 7 days of an asthma encounter, which was defined as an asthma exacerbation in this study.

Relationships of Tools to Exacerbations

Each tool and a history of prior exacerbations were significantly related (P < .0001) to future exacerbations (Tables 2, 3). Impairment indicated by each tool individually was also significantly related to future exacerbations above and beyond the risk conferred by prior exacerbations (Tables 2, 3). When prior exacerbations were not considered, the mAQLQ and ACT provided independent information in the prediction of future exacerbations (Table 3). However, when prior exacerbations were included in the model, the three impairment tools provided similar and overlapping information, such that only the mAQLQ entered the model (Table 3).

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Factor Analysis

The three final factors explained 97.8% of the variability (Table 4). Based on the questions with the highest loading on each factor, the factors were named.

Table 1—Baseline Characteristics of the 2,680 Patients Included in the Study

Characteristic Results
Age 44.9 (11.0)
69.7
Race/ethnicity
White 54.2
Black 10.9
Hispanic 21.6
Asian/Pacific Islander 7.6
Other/unknown 5.7
Education
Less than high school 3.6
High school graduate or equivalent 18.9
Some college 35.7
College graduate 21.2
Postgraduate or professional degree 20.6
Current smokers 6.5
Regular inhaled corticosteroid therapy 73.6
Any asthma hospitalizations in past 12 mo 4.1
Other unscheduled visits for asthma in past 12 mo 31.6
Oral corticosteroid use in past 12 mo 39.9
ACT score 18.7 (4.5)
mAQLQ score 5.0 (1.3)
AIS-6 score 47.9 (9.9)

Data presented as frequency (%) or mean (SD). ACT = Asthma Control Test; AIS-6 = Asthma Impact Survey; mAQLQ = mini-Asthma Quality of Life Questionnaire.

Table 2—Relationships of Asthma Control and Quality-of-Life Tool Scores and Prior Asthma Exacerbations to Future Asthma Exacerbations: Bivariate Analyses

Predictor Predictor Present Predictor Absent
ACT <16 31.4 20.0
mAQLQ < 4.7 30.4 19.0
AIS-6 >60 35.6 21.7
Prior exacerbations 33.7 14.6

Data are presented as % exacerbations. All P < .0001. See Table 1 legend for expansion of abbreviations.

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