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Patient-Reported Outcome in Two Chronic Diseases: A Comparison of Quality of Life and Response Profiles in Severe Migraine and Severe Asthma

Authors Lucas C, Aly S, Touboul C, Sellami R, Guillaume X, Garcia G

Received 9 July 2019

Accepted for publication 6 December 2019

Published 7 February 2020 Volume 2020:11 Pages 27—37


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Lynne Nemeth

Christian Lucas,1 Samia Aly,2 Chantal Touboul,3 Rahma Sellami,3 Xavier Guillaume,3 Gilles Garcia4

1Centre d’Evaluation et de Traitement de la Douleur, Service de Neurochirurgie, Hôpital Salengro, CHRU de Lille, Lille, France; 2Novartis Pharma, Rueil-Malmaison, France; 3Kantar, Montrouge, France; 4Service de Pneumologie, Hôpital Bicêtre, CHU Paris Sud, Kremlin-Bicetre, France

Correspondence: Christian Lucas
Centre d’Evaluation et de Traitement de la Douleur, Service de Neurochirurgie, Hôpital Salengro, CHRU de Lille, Lille, France
Tel +33 3 20 44 60 76

Introduction: Migraine and asthma are two frequent, disabling, chronic disorders with a major impact on patient well-being. The objectives of this study were to compare subjective well-being between patients with severe forms of migraine or asthma using a panel of PROs.
Methods: Adult patients were recruited during routine consultations with chest physicians or neurologists. Patients with severe migraine (reporting headaches on ≥ 8 days/month and having failed ≥ 2 prophylactic treatments) and patients with severe asthma (according to the 2017 GINA definition: requiring Step 4 or 5 treatment or presenting uncontrolled symptoms) were eligible. Each patient completed the EuroQol Questionnaire (EQ-5D-5L), the Work Productivity and Activity Impairment Questionnaire (WPAI) and the Hospital Anxiety and Depression scale (HAD). Patients with severe migraine the 6-item Headache Impact Test (HIT-6) and those with severe asthma completed the Asthma Control Test (ACT).
Results: 249 patients with severe migraine and 96 with severe asthma were enrolled. Mean EQ-5D-5L utility scores were significantly higher in the severe migraine group than in the severe asthma group (0.75± 0.25 vs 0.68± 0.26; p< 0.01). Low EQ-5D-5L utility scores were associated with frequent (≥ 15 headache days/month) or disabling (HIT-6 score ≥ 60) headaches and with poor asthma control. Patients with severe migraine more frequently presented a HAD depression score ≥ 11 (23.0% in severe migraine; 7.5% in severe asthma; p< 0.01), whereas those with severe asthma more frequently reported problems with mobility, self-care and usual activities. Absenteeism (percent worktime missed) was similar in both groups (severe migraine: 9.0%± 19.1%; severe asthma: 13.8%± 22.9%) but work impairment was higher in the severe migraine group (44.3% vs 28.4%; p< 0.01).
Conclusion: Quality of life, work activity and psychological distress are all deteriorated in both severe migraine and severe asthma. Different aspects are affected in the two diseases: a greater impact on psychological aspects in severe migraine and a greater impact on physical aspects in severe asthma.

Keywords: quality of life, work performance, psychological distress, asthma, migraine

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