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ABSTRACT: Introduction: Respiratory allergic disorders like rhinitis and asthma are common conditions that not only affect target organs, but complicate the daily life of affected children and adolescents. Objectives: The aim of this study was to investigate the QoL (quality of life) in children with grass pollen allergy in and out of grass pollen season. Methods: We used the Pediatric Allergic Disease Quality of Life Questionnaire (PADQLQ), a disease-specific questionnaire including both asthma and rhinitis symptoms. We also used the DISABKIDS (a European project which aims at enhancing the quality of life and the independence of children with chronic health conditions and their families) questionnaire, a generic questionnaire covering non-organ-specific effects of disease. Results: Ninety-eight children 7-18 years old with grass pollen allergy were included. Eighty-nine children (91%) completed the study. The QoL was significantly decreased during pollen season assessed both with DISABKIDS and PADQLQ. The correlation between the questionnaires was 0.73. Not only the physical domain score (P = 0.00093) but also the emotional domain score (P = 0.034) was significantly lowered. Children with multiple manifestations (asthma and rhinitis) had lower QoL than children with rhinitis alone (P = 0.01). Multiple regression analysis showed a highly significant impact on QoL for symptoms from nose, eyes and lungs. They were equally important (standardized coefficient 047, 0.47 and 0.46, respectively). Conclusion: The QoL in children and adolescents with respiratory allergy deteriorates during pollen season. This was shown both with generic (DISABKIDS) and disease-specific instrument (PADQLQ). Please cite this paper as: Kiotseridis H, Cilio CM, Bjermer L, Aurivillius M, Jacobsson H, Dahl Å and Tunsäter A. Quality of life in children and adolescents with respiratory allergy, assessed with a generic and disease-specific instrument. Clin Respir J 2012; DOI:10.1111/j.1752-699X.2012.00298.x.
The Clinical Respiratory Journal 05/2012; · 1.06 Impact Factor
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ABSTRACT: Several instruments have been developed for measuring asthma control, but there is still a need to provide a structure for primary care asthma reviews.
The Active Life with Asthma (ALMA) tool was developed with the aim of structuring patient visits and assessing asthma treatment in primary care. The ability of ALMA to map out the care of asthma patients was evaluated and validated.
ALMA was developed with patient and clinical expert input. Questions were generated in focus groups and the resulting tool was subsequently validated by factor analysis in 1779 patients (1116 females) of mean age 51 years (range 18-89) in primary care.
The ALMA tool includes 19 questions, 14 of which belong to a subset assessing asthma control. In this subset, factor analysis revealed three domains (factors): physical, psychological, and environmental triggers. Correlation with the Asthma Control Questionnaire was 0.72 and the Cronbach's alpha was 0.88. The test-retest reliability was 0.93. Of the 1779 patients tested with ALMA in primary care, 62% reported chest tightness, 30% nightly awakenings and 45% asthma breakthrough despite medication.
The ALMA tool is useful as a follow-up instrument in clinical practice to structure patient visits and assess asthma treatment in primary care. The breadth of the questions and the pragmatic use in clinical practice also make it useful as an outcome measure.
Primary care respiratory journal: journal of the General Practice Airways Group 01/2012; 21(2):139-44.
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ABSTRACT: The aim of the study was to translate and validate the PADQLQ (Pediatric Allergic Disease Quality of Life Questionnaire), a disease-specific quality of life questionnaire for the assessment of quality of life in children with pollen allergy.
The PADQLQ was translated into Swedish according to guidelines. Children aged 7-18 with grass pollen allergy were included. Quality of life was assessed in parallel with ordinary symptom scales (VAS) before, during and after the pollen season.
A total of 98 children were included and 89 (91%) completed the study. The results for PADQLQ showed good cross-sectional and longitudinal validity. The retrospective estimation after the season showed good consensus with the assessment during pollen season.
Quality of life in children assessed with the PADQLQ (Pediatric Allergic Disease Quality of Life Questionnaire) is a reliable strategy for evaluating the burden of disease in children with pollen allergy and for the evaluation of treatment.
Acta Paediatrica 02/2011; 100(2):242-7. · 2.07 Impact Factor
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ABSTRACT: The present investigation was designed to evaluate the health-related quality of life (HRQOL) of adolescents with asthma between the age of 16 and 21, when they are transferred from paediatric to adult care.
In this prospective study, 156 teenagers (69 females) with asthma were screened employing spirometry, a histamine challenge, skin prick test for allergy and filled out the 'Living with Asthma Questionnaire' both at the time of entry into the study and after 2 and 5 years of follow-up. An exercise test and questions concerning regular performed exercise were carried out at baseline and 5 years later.
At all three time-points, the HRQOL of the men was generally better than that of the women. At the same time, the HRQOL of both genders was significantly better, both in terms of the overall scores (P < 0.001) as well as the scores for most of the individual domains, in connection with the 5-year follow-up. The young women who exercised regularly at the time of their entry exhibited better HRQOL at this time than those who did not (P < 0.001), whereas regular exercise had no impact on the HRQOL of the young men. The women with severe asthma demonstrated a poorer HRQOL than those suffering from mild-to-moderate asthma.
The HRQOL of adolescents with asthma improves with age. The pronounced positive correlation between regular exercise and HRQOL in female adolescents with asthma revealed here deserves special attention in the care of young women and deserves further exploration.
The Clinical Respiratory Journal 07/2010; 5(4):195-202. · 1.06 Impact Factor
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ABSTRACT: The aim was to study health-related quality of life, five years after an intervention study among young adults with asthma.
The design was a follow-up study of a cohort of young adults with asthma (n=64) and 248 general population controls. Both groups were investigated at follow-up with a respiratory questionnaire and one generic quality-of-life instrument, and the asthma cohort also completed one-asthma-specific questionnaire. The material was analyzed with multivariate models.
Female gender and low FEV1 at baseline predicted both a decline during follow-up and a low quality of life at follow-up. The asthma cohort and controls scored similarly regarding generic quality of life. However, in the asthma cohort, females scored significantly lower in the physical dimension of the generic instrument, especially in the domain of general health.
There is an association between low FEV1 and a decline in quality of life among young adults with asthma, i.e. low FEV1 predicts a decline in quality of life during a five-year period. Young females with asthma seem to have lower quality of life compared with young males with asthma.
Respiratory medicine 06/2009; 103(10):1580-5. · 2.33 Impact Factor
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John Haughney,
David Price,
Alan Kaplan,
Henry Chrystyn,
Rob Horne,
Nick May,
Mandy Moffat,
Jennifer Versnel,
Eamonn R Shanahan,
Elizabeth V Hillyer, Alf Tunsäter,
Leif Bjermer
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ABSTRACT: Achieving asthma control remains an elusive goal for the majority of patients worldwide. Ensuring a correct diagnosis of asthma is the first step in assessing poor symptom control; this requires returning to the basics of history taking and physical examination, in conjunction with lung function measurement when appropriate. A number of factors may contribute to sub-optimal asthma control. Concomitant rhinitis, a common co-pathology and contributor to poor control, can often be identified by asking a simple question. Smoking too has been identified as a cause of poor asthma control. Practical barriers such as poor inhaler technique must be addressed. An appreciation of patients' views and concerns about maintenance asthma therapy can help guide discussion to address perceptual barriers to taking maintenance therapy (doubts about personal necessity and concerns about potential adverse effects). Further study into, and a greater consideration of, factors and patient characteristics that could predict individual responses to asthma therapies are needed. Finally, more clinical trials that enrol patient populations reflecting the real world diversity of patients seen in clinical practice, including wide age ranges, presence of comorbidities, current smoking, and differing ethnic origins, will contribute to better individual patient management.
Respiratory medicine 10/2008; 102(12):1681-93. · 2.33 Impact Factor
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ABSTRACT: Respiratory symptoms are related to anxiety and depression in several cross-sectional studies but the association has not been explored in longitudinal studies.
To prospectively study the change in dyspnea in relation to symptoms of anxiety and depression over a 9-year time period.
The study comprised of 515 adults from a population sample who had participated in the European Commission Respiratory Health Survey (ECRHS) I in 1991-1992 and in the ECRHS II in 1999-2000. The questionnaire included a modified British Medical Research Council Scale for dyspnea grading and the Hospital Anxiety and Depression scale questionnaire.
The prevalence of dyspnea was 10.7% in the first and 12.6% in the second survey. Symptoms of depression was an independent determinants for dyspnea in both surveys (OR (95% CI) 3.72 (1.51-9.17) and 3.40 (1.49-7.80), respectively). In subjects that did not have dyspnea at the first survey onset of symptoms of anxiety (OR 3.53 (1.03-12.1)) and depression (OR 12.2 (3.97-37.5)) were significantly related to having dyspnea at the second survey, whereas onset of dyspnea was not significantly associated with developing symptoms of anxiety or depression when each disorder was entered separately.
Our data indicates that there is a causal relationship between development of symptoms of anxiety and depression and dyspnea. Psychological status is therefore an important factor to consider both when evaluating the results of epidemiological respiratory studies and in clinical settings when treating patients that have dyspnea.
Respiratory Medicine 11/2006; 100(10):1843-9. · 2.47 Impact Factor
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ABSTRACT: The aims of the study were to assess the accuracy of self-reported asthma and notified year of asthma onset.
The study was performed on a sample of 365 subjects, 18-60 years old, with clinically diagnosed onset of asthma between 1983 and 1986. All subjects were investigated 10 years later, in 1996, with a respiratory questionnaire about the items of asthma and year of onset. The material was analyzed with logistic regression models.
Of the 289 subjects who returned the questionnaire, asthma was reconfirmed in 251 subjects. In a logistic regression model, asthma severity was significantly associated with confirmation of asthma. The median difference between the "true" year of onset and the reported year 10 years later, the recall period was zero, with a 10th to 90th interpercentile range of -2 to 6 years. The recall period was not associated with asthma severity, bronchial hyperresponsiveness, smoking, atopy, or sex.
Self-reported asthma is biased in relation to disease severity, meaning that subjects with mild disease were less prone to report their asthma. Reported year of asthma onset among adults seems to be rather accurate, with no obvious dependent misclassifications.
Journal of Clinical Epidemiology 02/2006; 59(1):90-3. · 4.27 Impact Factor
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ABSTRACT: The aim of the study was to assess the effectiveness of a computerized limited asthma education program, designed to suit young people. The study was conducted with 97 young adults (18-25 years) with asthma, 48 were randomized to the intervention group and 49 to the control group, and they were followed for 12 months. The intervention group completed an interactive computer program of 30-min duration providing information about asthma, mechanisms, trigger factors, allergies and medication use, which was followed by a 30-min discussion with a specialized asthma nurse. The control group followed the routine schedule for asthma outpatients. The outcomes of the study were number of hospital admissions, emergency visits, asthma symptoms, knowledge about asthma, lung function and quality of life. No effect was found regarding admission to hospital, emergency visits, prevalence of respiratory symptoms, knowledge of asthma or quality of life. However, forced exhaled volume in 1s (FEV(1)) increased significantly, mainly among the atopic subjects. In conclusion, an intervention with a limited asthma education program did not show an effect on asthma symptoms, asthma knowledge or quality of life parameters.
Respiratory Medicine 04/2005; 99(3):321-8. · 2.47 Impact Factor
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ABSTRACT: In this study we evaluated how the quality of life in subjects with asthma was affected by a history of non-infectious rhinitis. The study comprised 180 persons with asthma and 156 controls, who answered the Short Form 36 quality of life questionnaire. Both the asthma subjects and the controls were stratified according to a history of non-infectious rhinitis (NIR). The global physical quality of life score (PCS) was significantly lower for all the asthma subjects regardless of their previous history of NIR compared to controls (NIR positive asthma, -8, p=O,001, NIR negative asthma, -9, p=0, 001). The subjects with asthma and a positive history of NIR obtained significantly lower scores for their global mental quality of life (MCS) than the controls (46 vs 51, p=0.004). The subjects with asthma and a negative history of NIR obtained MCS scores that were similar to those of the controls (50 and 51, p=0.9). In this population based study, the physical Qol of the subjects with asthma was lower regardless of a previous history of NIR compared to controls. A positive history of NIR in asthma was however associated with a poorer mental Qol.
Rhinology 01/2005; 42(4):183-8. · 1.32 Impact Factor
