Quality of life and autonomy preferences in stable asthmatics: A developing country scenario

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Background and objectiveThe quality of life (QOL) and autonomy preferences of asthmatics in developing countries have been sparingly researched, with a resulting lack of management strategies. This study determined the asthma-specific QOL and autonomy preferences of a population of asthmatics in a developing country and their association with relevant sociodemographic and clinical characteristics.MethodsA cross-sectional study using the Asthma Quality of Life Questionnaire and the Asthma Autonomy Questionnaire was performed on a population of stable asthmatics recruited from a tertiary care centre in India. Severity of the disease was assessed by spirometry.ResultsThe study population comprised 80 asthmatics. The mean (SD) overall QOL score was 5.04 (0.97). This was significantly associated with history of hospitalization during the previous year for an asthma attack (P < 0.01) and with FEV1 (P < 0.05) on univariate analysis; on multivariate analysis, only history of hospitalization was significant. Autonomy preferences of the patients showed higher scores for information-seeking (mean (SD) = 78.95 (16.35)) than decision-making (mean (SD) = 38.21 (14.6)). The information-seeking preferences had a negative correlation with age (P < 0.01) and a positive correlation with education status (P < 0.01) and decision-making correlated with education status (P < 0.05). A minority of patients (19%) indicated a preference for a greater say in decision-making than their physicians. There was a lower tendency for decision-making when given a ‘severe exacerbation’ scenario than in ‘mild exacerbation’ (P < 0.001) or ‘stable disease’ (P < 0.001).ConclusionsHospitalization history and FEV1 values are the parameters having the most significant impact on the QOL of asthmatics. There is a clear desire to obtain more information about the disease but most patients do not endorse the idea of making independent disease-related decisions.

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