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Relationship between quality of life and clinical status in asthma: a factor analysis

¹ Dept of Clinical Epidemiology and Biostatistics, McMaster University, and ⁴ Firestone Institute for Respiratory Health and Dept Medicine, McMaster University, Hamilton, Ontario, Canada. ² GlaxoSmithKline, Research Triangle Park, NC, and ³ Pfizer Inc., New York City, NY, USA

CORRESPONDENCE: E. Juniper, 20 Marcuse Fields, Bosham, West Sussex, PO18 8NA, UK. Fax: 44 1243573680. E-mail: juniper@qoltech.co.uk

Keywords: asthma, health status, measurement, quality of life

Received: June 6, 2003
Accepted November 17, 2003

This study was supported by GlaxoSmithKline R&D.

Many studies have shown that correlation between clinical asthma status and asthma-specific quality of life is only weak to moderate. However, this relationship has never been explored to determine whether the weakness is due to noise of measurement or whether quality of life is a distinct component of asthma health status.

With a database from three clinical trials (n=763), factor analysis was used to explore the relationships between quality of life, measured by the Asthma Quality of Life Questionnaire (AQLQ), and conventional measures of asthma clinical status (symptoms, airway calibre and rescue ß₂-agonist use).

The analysis revealed that although patients with severe, poorly controlled asthma tend to have worse quality of life than milder, well-controlled patients, overall asthma health status has four components (factors): asthma-specific quality of life; airway calibre; daytime symptoms and daytime ß₂-agonist use, and night-time symptoms and night-time ß₂-agonist use.

The clean loading of all 21 outcomes onto four distinct and clinically identifiable factors suggests that, although some weakness of correlation between clinical indices and quality of life may be due to noise of measurement, it is mainly attributable to asthma health status being composed of distinct components.

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