Journal Information
Vol. 14. Issue 4.
Pages 459-486 (July - August 2008)
Share
Share
Download PDF
More article options
Vol. 14. Issue 4.
Pages 459-486 (July - August 2008)
Artigo Original/Original Article
Open Access
Estudo nacional de qualidade de vida na asma – Aplicação do Asthma Quality of Life Questionnaire de Marks (AQLQ-M) na população portuguesa
National study of asthma quality of life – Application of the Asthma Quality of Life Questionnaire (AQLQ-M) by Marks in the portuguese population
Visits
5987
Jorge Ferreira1, Pedro Silveira2, J. Agostinho Marques3
1 Serviço de Pneumologia – Hospital Pedro Hispano – Unidade Local de Saúde de Matosinhos / Pulmonology Unit, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos
2 Departamento de Cuidados Intensivos – Hospital Pedro Hispano – Unidade Local de Saúde de Matosinhos / Intensive Care Unit, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos
3 Serviço de Pneumologia – Hospital de S. João, Porto / Pulmonology Unit, Hospital de S. João, Oporto
This item has received

Under a Creative Commons license
Article information
Resumo

A versão portuguesa do Asthma Quality of Life Questionnaire de Marks (AQLQ-M) demonstrou anteriormente que apresenta boas propriedades psicométricas e é adequada para utilização em doentes portugueses com asma. Ao longo dos últimos 40 anos, tem vindo a observar-se um aumento global na prevalência, morbilidade, mortalidade e custos económicos associados à asma, continuando esta a ser uma doença subdiagnosticada e subtratada. Neste estudo, o AQLQ-M foi aplicado a 826 doentes asmáticos de Portugal continental (97,9% caucasianos; média de idades=40,5 anos; 30,2% do sexo masculino; 69,8% do sexo feminino) seguidos em consulta de pneumologia ou imunoalergologia. Os doentes foram classificados de acordo com os níveis de gravidade do Global Initiative for Asthma (GINA). Apresentavam asma intermitente 40,5%; 26,9% asma persistente ligeira; 21,4% asma persistente moderada e 11,2% asma persistente grave. A pontuação do AQLQ-M manteve correlações estatisticamente significativas com a gravidade da asma, sintomas e função pulmonar. A maioria dos doentes não se apresentava controlada, tendo 74,6% recorrido ao serviço de urgência ao longo do último ano. Para todas as subescalas do questionário, as mulheres apresentavam pior qualidade de vida (QdV) do que os homens. Surpreendentemente, os fumadores apresentavam melhor QdV do que os indivíduos que nunca fumaram. Os resultados deste estudo revelaram que a versão portuguesa do AQLQ-M é um instrumento útil para a medição da QdV relacionada com a saúde em adultos com asma.

Rev Port Pneumol 2008; XIV (4): 459-486

Palavras-chave:
Asma
qualidade de vida
questionários
Abstract

The Portuguese version of the Marks Asthma Quality of Life Questionnaire (AQLQ-M) has already proven to have good diagnostic properties, and is suitable for use with Portuguese asthma patients. The last forty years have seen a worldwide rise in the rate, morbidity, mortality and economic burden associated with asthma and the disease continues to be underdiagnosed and undertreated. In this study the AQLQ-M was administered to 826 asthmatic patients from continental Portugal (97.9% Caucasian, mean age 40.5years, 30.2% male, 69.8% female), followedup by pulmonologists and allergologists. Patients were classified in line with the Global Initiative for Asthma (GINA) severity categories: 40.5% intermittent asthma, 26.9% mild persistent, 21.4% moderate persistent, 11.2% severe persistent. AQLQ-M scores maintained significant relationships with asthma severity, symptoms and lung function. Most of the patients were not managed and 74.6% were observed in an emergency room during last year. Women reported poorer QoL than men in all the questionnaire’s subscales. Surprisingly, smokers presented better QoL than non-smokers. The results of this study evidence that the Portuguese version of the AQLQ-M is a useful instrument for measuring health-related quality of life in adults with asthma.

Rev Port Pneumol 2008; XIV (4): 459-486

Key-words:
Asthma
quality of life
questionnaires
Full text is only aviable in PDF
Bibliografia / Bibliography
[1.]
S.S. Braman.
The Global Burden of Asthma Chest, 130 (2006), pp. 4S-12S
[2.]
P.W. Jones.
Quality of life measurement in asthma.
Eur Respir J, 8 (1995), pp. 885-887
[3.]
G.H. Guyatt, D.H. Fenny, D.L. Patrick.
Measuring healthrelated quality of life.
Ann Intern Med, 118 (1993), pp. 622-629
[4.]
Nocturnal Oxygen Therapy Group.
Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial.
Ann Intern Med, 93 (1980), pp. 391-398
[5.]
R.F. Lockey, et al.
Nocturnal Asthma – Effect of Salmeterol on Quality of Life and Clinical Outcomes.
Chest, 115 (1999), pp. 666-673
[6.]
Wojciech A. Biernacki, Sergei A. Kharitonov, Helen M. Biernacka, P.J. Barnes.
Effect of Montelukast on Exhaled Leukotrienes and Quality of Life in Asthmatic Patients.
Chest, 128 (2005), pp. 1958-1963
[7.]
Elizabeth F. Juniper, A. Sonia Buist.
HealthRelated Quality of Life in Moderate Asthma: 400μg Hydrofluoroalkane Beclomethasone Dipropionate vs 800μg Chlorofluorocarbon Beclomethasone Dipropionate.
Chest, 116 (1999), pp. 1297-1303
[8.]
C.P. van Schayck, M.P. Rutten-van Molken, E.K. van Doorslaer, H. Folgering, C. van Weel.
Two-year bronchodilator reatment in patients with mild airflow obstruction. Contradictory effects on lung function and quality of life.
Chest, 102 (1992), pp. 1384-1391
[9.]
Gustavo J. Rodrigo, Carlos Rodrigo, Jesse B. Hall.
Acute Asthma in Adults: A Review.
Chest, 125 (2004), pp. 1081-1102
[10.]
J. Paul Leigh, Patrick S. Romano, Marc B. Schenker.
Kathleen Kreiss Costs of Occupational COPD and Asthma.
Chest, 121 (2002), pp. 264-272
[11.]
K.B. Weiss, P.J. Gergen, T.A. Hodgson.
An economic evaluation of asthma in the United States.
N Engl J Med, 326 (1992), pp. 862-866
[12.]
D.H. Smith, D.L. Malone, K.A. Lawsen, et al.
A national estimate of the economic costs of asthma.
Am J Respir Crit Care Med, 156 (1997), pp. 787-793
[13.]
Sandra D. Thomas, Steve Whitman.
Asthma Hospitalizations and Mortality in Chicago: An Epidemiologic Overview.
Chest, 116 (1999), pp. 135-141
[14.]
C.S. Ulrik, J. Frederiksen.
Mortality and markers of risk of asthma death among 1075 outpatients with asthma.
Chest, 108 (1995), pp. 10-15
[15.]
G.B. Marks, S.M. Dunn, A.J. Woolcock.
An evaluation of asthma quality of life questionnaire as a measure of change in adults with asthma.
J Clin Epidemiol, 46 (1993), pp. 1103-1111
[16.]
J. Ferreira, P. Silveira, M.M. Figueiredo, C. Andrade, F. João, A. Marques.
Validação da versão portuguesa do Asthma Quality of Life Questionnaire de Marks (AQLQM).
Rev Port Pneumol, XI (2005), pp. 351-366
[17.]
K.N. Lohr, N.K. Aaronson, J. Alonso, et al.
Evaluating quality-of-life and health status instruments: Development of scientific review criteria.
Clin Ther, 18 (1996), pp. 979-992
[18.]
J.C. Nunnally.
Psycometric Theory, 2, pp. 245
[19.]
GINA.
Update: Workshop Report, Global Strategy for Asthma Management and Prevention.
(2005),
[20.]
Centers for Disease Control, Prevention.
Self-reported asthma prevalence among adults – United States, 2000.
MMWR Morb Mortal Wkly Rep, 50 (2001), pp. 682-686
[21.]
Centers for Disease Control, Prevention.
Surveillance for asthma – United States, 1960-1995.
MMWR Morb Mortal Wkly Rep, 47 (1998), pp. SS-1
[22.]
National Asthma Education and Prevention Program Expert Panel Report.
Guidelines for the Diagnosis and Management of Asthma 1991, National Institutes of Health, (1991),
[23.]
A.L. Sheffer.
for the International Asthma Management Project. International consensus report on diagnosis and treatment of asthma. DJJS NIH publication 92-3091.
Eur Respir J, 5 (1992), pp. 601-641
[24.]
Global Strategy for Asthma Management and Prevention.
[25.]
A.L. Fuhlbrigge, R.J. Adams, T.W. Guilbert, et al.
The burden of asthma in the United States: level and distribution are dependent on interpretation of the national asthma education and prevention program guidelines.
Am J Respir Crit Care Med, 166 (2002), pp. 1044-1049
[26.]
K.F. Rabe, P.A. Vermeire, J.B. Soriano, W.C. Maier.
Clinical management of asthma in 1999: the asthma insights and Reality in Europe (AIRE) study.
Eur Respir J, 16 (2000), pp. 802-807
[27.]
D.M. Mannino, D.M. Homa, L. Akinbami, et al.
Surveillance for asthma – United States 1980-99.
MMWR Surveil Summ, 51 (2002), pp. 1-13
[28.]
E. Horak, S.M. Sawyer, M. Roberts, A. Lanigan, J.B. Carlin, A. Olinsky, C.F. Robertson.
Impact of disease severity on quality of life in adults with asthma.
Wien Klin Wochenschr, 117 (2005), pp. 462-467
[29.]
E.F. Juniper, G.H. Guyatt, P.J. Ferrie, L.E. Griffith.
Measuring quality of life in asthma.
Am Rev Respir Dis, 147 (1993), pp. 832-838
[30.]
R.W. Broyles, W.J. MacAuley, D. Baird-Holmes.
The medically vulnerable: their health risks, health status, and use of physician care.
J Health Care Poor Underserved, 10 (1999), pp. 186-200
[31.]
B.H. Rowe, A.D. Oxman.
Performance of an asthma quality of life questionnaire in an outpatient setting.
Am Rev Respir Dis, 148 (1993), pp. 675-681
[32.]
L.D. Ried, D.P. Nau, T.J. Grainger-Rousseau.
Evaluation of patient’s Health-Related Quality of Life using a modified and shortened version of Living With Asthma Questionnaire (ms-LWAQ) and the medical outcomes study, Short-Form 36 (SF-36).
Qual Life Res, 8 (1999), pp. 491-499
[33.]
L.M. Osman, D.J. Godden, J. Friends, J.S. Legge.
Quality of life and hospital re-admission in patients with COPD.
Thorax, 52 (1997), pp. 67-71
[34.]
S.F. Vincent, J.R. Curtis, Shin-Ping Tu, M.B. McDonell, S.D. Fihn.
Using Quality of Life to Predict Hospitalization and Mortality in patients With Obstructive Lung Diseases.
Chest, 122 (2002), pp. 429-436
[35.]
M. Schatz, S. Clark, C.A. Camargo.
Sex differences in the presentation and course of asthma hospitalizations.
Chest, 129 (2006), pp. 50-55
[36.]
N.W. Johnston, M.R. Sears.
Asthma exacerbations. 1: epidemiol.
Thorax, 61 (2006), pp. 722-728
[37.]
National Health Survey.
First results Australia.
Australian Bureau of Statistics, (1996),
[38.]
R.J. Adams, D.H. Wilson, A.W. Taylor, A. Daly, E.T. d’Espaignet, E.D. Grande, R.E. Ruffin.
Coexistent Chronic Conditions and Asthma Quality of Life: A Population-Based Study.
Chest, 129 (2006), pp. 285-291
[39.]
M.R. Niefeld, J.B. Braunstein, A.W. Wu, et al.
Preventable hospitalization among elderly Medicare beneficiaries with type 2 diabetes.
Diabetes Care, 26 (2003), pp. 1344-1349
[40.]
G.B. Diette, J.A. Krishnan, F. Dominici, et al.
Asthma in older patients: factors associated with hospitalization.
Arch Intern Med, 163 (2002), pp. 1123-1132
[41.]
H.A. Wijnhoven, D.M. Kriegsman, A.E. Hesselink, et al.
The influence of co-morbidity on health-related quality of life in asthma and COPD patients.
Respir Med, 97 (2003), pp. 468-475
[42.]
H.A. Wijnhoven, D.M. Kriegsman, A.E. Hesselink, et al.
Determinants of different dimensions of disease severity in asthma and COPD: pulmonary function and health-related quality of life.
Chest, 119 (2001), pp. 1034-1042
[43.]
J.B. Austin, S. Selvaraj, D. Godden, G. Russell.
Deprivation, smoking, and quality of life in asthma Archives of Disease in Childhood, 90 (2005), pp. 253-257
[44.]
S. Rietveld, W. Everaerd.
Perceptions of Asthma by Adolescents at Home.
Chest, 117 (2000), pp. 434-439
[45.]
E.R. McFadden, R. Kiser, W.J. de Groot.
Acute bronchial asthma: relations between clinical and physiological manifestations.
N Engl J Med, 288 (1973), pp. 221-225
[46.]
A.R. Rubinfeld, M.C.F. Pain.
Perception of asthma.
Lancet, II (1976), pp. 882-884
[47.]
P.J. Barnes.
Blunted perception and death from asthma (editorial comments).
N Engl J Med, 330 (1994), pp. 1383-1384
[48.]
A.H. Kendrick, G. Laszlo, C.M.B. Higgs, et al.
Clinical features associated with poor perception of asthma in the community [abstract].
Am J Respir Crit Care Med, 151 (1995), pp. A472
[49.]
S. Rietveld.
Symptom perception in asthma: a multidisciplinary review.
J Asthma, 35 (1998), pp. 137-146
[50.]
C.M.B. Higgs, G. Laszlo.
Influence of treatment with beclomethasone, cromoglycate, and theophylline.
Clin Sci, 90 (1996), pp. 227-234
[51.]
Y. Kikuchi, S. Okabe, G. Tamura, et al.
Chemosensitivity and perception of dyspnea in patients with a history of near-fatal asthma.
N Engl J Med, 330 (1994), pp. 1329-1334
[52.]
P.M. Yellowlees, R.E. Ruffin.
Psychological defenses and coping styles in patients following a life-threatening attack of asthma.
Chest, 95 (1989), pp. 1298-1303
[53.]
S. Rietveld, J.F. Brosschot.
Symptom perception in asthma: a biomedical and psychological review.
Int J Behav Med, 6 (1999), pp. 120-135
[54.]
R. Magadle, N. Berar-Yanay, P. Weiner.
The risk of hospitalization and near-fatal and fatal asthma in relation to the perception of dyspnea.
Chest, 121 (2002), pp. 329-333
[55.]
A.L. Fuhlbrigge, B.T. Kitch, A.D. Paltiel, et al.
FEV-1 is associated with risk of asthma attacks in a pediatric population.
J Allergy Clin Immunol, 107 (2001), pp. 61-67
[56.]
B.T. Kitch, A.D. Paltiel, K.M. Kuntz, et al.
A single measure of FEV-1 is associated with risk of asthma attacks in long term follow-up.
Chest, 126 (2004), pp. 1875-1882
[57.]
M. Noonan, P. Chervinsky, W. Busse, et al.
Fluticasone propionate reduces oral prednisone use while it improves asthma control and quality of life.
Am J Respir Crit Care Med, 152 (1995), pp. 1467-1473
[58.]
L.J. Okamoto, M. Noonan, B.P. DeBoisblanc, et al.
Fluticasone propionate improves quality of life in patients with asthma requiring oral corticosteroids.
Ann Allergy Asthma Immunol, 76 (1996), pp. 291-300
[59.]
B. Dryngel, S. Kesten, K.R. Champman.
Assesment of an ambulatory care asthma program.
J Asthma, 31 (1994), pp. 291-300
[60.]
L. Agertoft, S. Pedersen.
Effects of long term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children.
Respir Med, 88 (1994), pp. 373-381
[61.]
B.A. Otulana, N. Varma, A. Bullock, T. Higenbottam.
High dose nebulized steroid in the treatment of chronic steroid-dependent asthma.
Repir Med, 86 (1992), pp. 105-108
[62.]
J. Corren, A.G. Hams, D. Aaronson, et al.
Efficacy and safety of loratidine plus pseudoephedrine in patients with seasonal allergic rhinitis and mild asthma.
J Allergy Clin Immunol, 100 (1997), pp. 781-788
[63.]
R.G. Ogirala, T.M. Strum, T.K. Aldrick, et al.
Single high-dose intramuscular triamcinolone acetonide versus weekly oral methotrexate in life-threatening asthma: a double-blind study.
Am J Respir Crit Care Med, 152 (1995), pp. 1461-1466
[64.]
J. Tamaoki, M. Kondo, N. Sakai, et al.
Leukotriene antagonist prevents exacerbation of asthma during reduction of high dose inhaled corticosteroid.
Am J Respir Crit Care Med, 155 (1997), pp. 1235-1240
[65.]
B. Dryngel, S. Kesten, K.R. Champman.
Assesment of an ambulatory care asthma program.
J Asthma, 31 (1994), pp. 291-300
[66.]
C. Craun-Fahrlander, M. Gassner, L. Grize, et al.
Comparison of responses to an asthma symptom questionnaire (ISAAC) completed by adolescents and their parents.
Pediatr Pulm, 25 (1998), pp. 159-166
[67.]
S. Shingo, J. Zhang, T.F. Reiss.
Correlation of airway obstruction and patient-reported endpoints in clinical studies.
Eur Respir J, 17 (2001), pp. 220-224
[68.]
P.J. Sharek, M.I. Mayer, L. Loewy, et al.
Agreement among measures of asthma status; a prospective study of low-income children with moderate to severe asthma.
Pediatrics, 110 (2002), pp. 797-804
[69.]
K. Gendo, S.D. Sullivan, P. Lozano, et al.
Resource costs for asthma-related care among pediatric patients in managed care.
Ann Allergy Asthma Immunol, 91 (2003), pp. 251-257
Copyright © 2008. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?