De gezondheidsgerelateerde kwaliteit van leven bij astma en COPD vergeleken met andere groepen in Nederland. Deel 2

This report, commissioned by the Dutch Asthma Foundation, gives an overview of available information on the health-related quality of life of persons with asthma or COPD in comparison with other groups. One of the means used was a literature search selecting Dutch studies that compared the quality of life in the Netherlands of persons with asthma or COPD to that of the general population or persons with other (chronic) diseases. In total 27 relevant studies were selected, 9 for children and 18 for adults. The other means was to carry out secondary analyses on data collected in three epidemiological studies. Health-related quality of life is a concept with multiple dimensions: the state of health, consequences of health for functioning and the appreciation given to levels of functioning are all important dimensions. Asthma and COPD may lead to physical and emotional complaints, and to limitations in physical, emotional and social functioning. The way functional limitations are experienced may vary from patient to patient. In children, asthma was associated with a deterioration of physical, emotional and social functioning. This relation was stronger for girls than for boys, stronger for 10 to 13-year-olds than for 7 to 9-year-olds, and stronger for children of parents with a lower education than for children of parents with a higher education. In children with asthma, having recent asthma complaints was associated with worse physical and emotional functioning. Compared to children with diabetes mellitus, children with asthma reported their physical functioning to be worse, but they were less worried about their disease. Children with asthma reported physical and social functioning to be worse than that reported by children with epilepsy. In adults, asthma and COPD were associated with a deterioration of health-related quality of life in terms of physical, emotional and social functioning. Persons with asthma or COPD also rated their health as being worse than that of the general population. Similar to the results for children, the reduction of quality of life associated with asthma and COPD was larger for women than for men; similarly, it was larger for older compared to younger persons and for lower educated people compared to higher educated people. The quality of life for those with COPD seemed worse than for persons with asthma, especially in terms of physical functioning, self-rated health and subjective experience. Compared to those with other diseases, adults with asthma or COPD reported, in general, a good quality of life, especially socially. As expected, quality of life was inversely associated with the severity of asthma or COPD. We conclude that future research into monitoring of, and changes in, quality of life in persons with asthma or COPD promises to be worthwhile, also in relation to course and severity of the disease, and to use and costs of care. A number of ongoing studies will be able to contribute to this. Further research is also needed for detection of specific risk factors for a poor quality of life in persons with asthma or COPD