NEW research has shown that the number of treatable traits independent of pharmacological care is associated with asthma control and quality of life (QoL). Data also suggests that referrals to treat these traits with non-medical professionals are rare.
Steffi Janssen, Basalt Rehabilitation Centre, Leiden, the Netherlands, and colleagues, conducted an observational, retrospective study involving 444 adult participants (mean FEV1: 88%±17%). Of these patients, 53% had uncontrolled asthma and decreased QoL based on the Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ).
The team proceeded to measure the prevalence of nine treatable traits: current smoking (15%), depressive mood (20%), severe dyspnoea (20%), overweight (20%), hyperventilation (30%), frequent exacerbations (30%), decreased exercise capacity (40%), physical inactivity (53%), and severe fatigue (60%). While no participants had all traits, 1% had eight, 2% had seven, 5% had six, 12% had five, 16% had four, 19% had three, 21% had two, 16% had one, and 7% had none.
Researchers further noted that the number of traits increased as asthma control worsened, with patients with uncontrolled asthma having 3.6±1.8 traits, while those with partially controlled asthma had 2.3±1.4 traits, and those with controlled asthma had 1.6±1.3 traits. Similarly, decreased QoL was associated with increased number of traits compared to good QoL (3.4±1.8 traits versus 1.7±1.2 traits). A weak correlation between the number of traits and FEV1 was also noted, as well as a moderate correlation between number of traits and ACQ/AQLQ. Those with severe dyspnoea, frequent exacerbations, overweight, or severe fatigue were at highest risk of impaired QoL.
They also examined treatment for these traits from a random sample of 95 patients, which showed that 33% of patients were referred to a specialised nurse, 20% to a physiotherapist, 2% to a psychologist, 1% to pulmonary rehabilitation, 5% to smoking cessation therapy, and 6% to a general practice-based nurse specialist.
The team concluded that the number of treatable traits patients have is associated with their asthma control and QoL, but that due to the low number of referrals to treat these traits, patients are left with a high burden of disease. Therefore, they recommend more structural screenings and appropriate referrals, as well as more research into effective treatments.
