An evaluation of the relationships between health-related quality of life, disease severity, healthcare utilization, and willingness to give time to an asthma self -management program

The objectives of this study were to: (1) quantify the amount of time patients are willing to devote to an asthma self-management program aimed at improving patient outcomes; (2) to evaluate the relationship between asthma patients\u27 perceived health-related quality of life (HRQL), disease severity, healthcare utilization, and their willingness-to-give-time (WTGT) to an asthma self-management program; and (3) to obtain a better understanding of the Health Belief Model as it relates to preventative health-seeking behavior. The sample for the study consisted of adult asthma patients enrolled in a managed care organization located in central Indiana. To measure HRQL, disease severity, and WTGT, eligible patients were mailed a questionnaire comprised of a generic HRQL scale (the Duke Health Profile), an asthma-specific HRQL scale (the Asthma Quality of Life Questionnaire - Marks), questions regarding the frequency of asthma symptoms, and a contingent valuation scenario measuring WTGT. Healthcare utilization data were obtained from a computerized medical record system. Data were collected during the months of February–April of 2000. The survey data were matched with the utilization data for all respondents. On average, patients were willing to spend 1.5 and 2.5 hours per week for four weeks in an asthma self-management program to experience up to a 45 percent (WTGT45) and 95 percent (WTGT95) improvement in their condition. There was a statistically significant relationship between overall asthma HRQL and WTGT (P \u3c 0.0001) while controlling for age. Symptom-based asthma severity also had a statistically significant relationship with WTGT, P = 0.0006 and P = 0.0092 for WTGT45 and WTGT95 respectively. The healthcare utilization measures did not have a statistically significant relationship with WTGT. HRQL explained more of the variance in WTGT the than symptom-based severity and healthcare utilization. The results suggest that one way to enhance participation in an asthma self-management program is to tell the potential participants an estimation of the magnitude of the program\u27s benefits. The findings also suggest that HRQL may be a good predictor of patients\u27 WTGT to an asthma self-management program thereby affording administrators the opportunity to create self-management programs tailored to the patients\u27 wants or needs