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Interaction effects of asthma and rhinitis control on work productivity and activity impairment: A cross-sectional study.

ABSTRACT: Background: Symptomatic asthma and rhinitis negatively impact patients' work productivity and activity. However, little is known about the potential interaction effect of both asthma and rhinitis control on work productivity and activity impairment. Objective: This study aimed to explore whether there are interaction effects of asthma and rhinitis control on work productivity and activity impairment in patients with asthma and with rhinitis. Methods: A total of 206 adult patients were prospectively recruited and were divided into four groups: both poorly controlled (BPC) n = 53), poorly controlled asthma (PCA) with controlled rhinitis (CR) (n = 38), well controlled asthma with uncontrolled rhinitis (n = 43), and both well controlled (BWC) (n = 72) based on the symptom control status of asthma and rhinitis. Work productivity loss and activity impairment, asthma control, and rhinitis control were assessed by using work productivity and activity impairment questionnaire: general health, the asthma control test, and the rhinitis control assessment test, respectively. General linear regression models were used to study the contribution of asthma control, rhinitis control, and the interaction effect on work productivity and activity impairment. Results: Work productivity loss was most frequently reported in patients in the BPC group. Compared with the patients in the BWC group, the patients in the PCA-CR group had significantly higher activity impairment and worse asthma-related quality of life (both p < 0.001). There were significant interaction effects of asthma and rhinitis control, which accounted for the increase in presenteeism, work productivity loss, and activity impairment (all p < 0.001). Although differences in absenteeism were not significant among the groups, there was a significant interaction effect of control levels accounted for absenteeism (p = 0.035). Conclusion: Distinct interaction effects of asthma and rhinitis control reflected a link between upper and lower airways, which indicated that rhinitis control and the interaction effects of asthma and rhinitis control cannot be neglected during asthma management.

SUBMITTER: Zhu WJ

PROVIDER: S-EPMC8677496 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundAdverse psychosocial working conditions-in particular poor job decision latitude and poor social support at work-may impair the effective implementation of asthma self-management behaviour at work and may be associated with increased asthma morbidity. In this study, we investigate for the first time the association of job decision latitude and social support at work with (1) four asthma-specific self-management behaviours at work (i.e., physical activity, trigger avoidance, acute symptom management, and communication) and with (2) asthma morbidity.MethodsA total of 221 employees with asthma recruited through three rehabilitation clinics completed questionnaires (response rate = 29.3%). Job decision latitude and social support were measured using items from the Copenhagen Psychosocial Questionnaire. The four asthma self-management behaviours were mainly assessed by self-developed items. We used the Asthma Control Test and the Marks Asthma Quality of Life Questionnaire to measure asthma morbidity. We dichotomized all variables and conducted logistic regression analyses to calculate odds ratios with 95% CIs.ResultsLow job decision latitude and low social support were significantly associated with poorer trigger avoidance (odds ratios ≥ 2.09) and poorer acute symptom management (odds ratios ≥ 2.29); low social support was further related to significantly less communication (odds ratio = 2.82). Low job decision latitude and low social support were also associated with significantly poorer asthma control (odds ratios ≥ 1.95) and poorer asthma-specific quality of life (odds ratios ≥ 2.05). The relationships with asthma morbidity were attenuated after adjustment for the four asthma self-management behaviours (odds ratios ranging from 1.1 to 1.9).ConclusionsAdverse psychosocial working conditions are associated with poorer asthma self-management behaviour at work and with increased asthma morbidity. The latter association may be mediated by asthma self-management behaviour.Trial registration German Clinical Trials Register, registration number: DRK S00011309, date of registration: 22.12.2016.

Project description:Background:Allergic respiratory diseases such as allergic rhinitis (AR) and allergic asthma (AA) are common conditions that can influence sleep and daytime functioning. However, the significance of this impact is unclear-particularly in perennial allergy sufferers. This study investigates the impact of perennial allergy on sleep, daily activities and productivity. Methods:Adults with self-reported or physician-diagnosed perennial AR aged ??18 years were recruited in Denmark, France, Germany and Sweden. Allergy sufferers were identified using online panels closely matching national population characteristics for each country. Impact on sleep, work, productivity and activity (by the Work, Productivity and Activity Index) were analysed. Descriptive analyses were conducted. Results:In total, 511 subjects with perennial AR (47.4% also with seasonal allergy) completed the survey. Most subjects (77.5%) had a physician-diagnosis of AR; 46.4% were diagnosed with both AA and AR. Most subjects (65.2%) reported sensitisation to house dust mites. Of all subjects, 66.0% reported sleep problems. Subjects with sleep problems woke, on average, 3.8 times per night, with 92.0% taking 15+ min to fall asleep (22.2% took 60+ min). Upon waking at night, 40.8% struggled to get back to sleep, and 69.2% had difficulties waking in the morning due to tiredness. Disturbances in daily functioning due to sleep issues were reported in 85.5-95.0% of subjects with sleep problems across all aspects investigated. Overall work and activity impairment were 53.3% and 47.1%, respectively. Sleep issues were more frequent (78.1% vs 54.7%) in those diagnosed with both AR and AA compared to AR alone, and more burdensome, with a greater impact on daily functioning (47.0% vs 33.3%) and impairment in work and activity (62.0% and 54.9% vs 39.3% and 35.2%, respectively). Of all subjects, 20.5% were receiving AIT at the time of the survey; of these, 36.4% reported moderate or great improvement in sleep due to allergy treatment. Conclusions:In perennial AR sufferers, sleep problems are common and impact on daily functioning, with results indicating a greater burden in those with both AR and AA compared to AR alone.

Project description:IntroductionThe Work Productivity and Activity Impairment Specific Health Problem Questionnaire (WPAI:SHP) is used to assess the impact of an intervention on work productivity in patients with psoriatic arthritis (PsA). Unfortunately, studies reporting changes or improvements in domains of WPAI:SHP by patients with PsA have a limited threshold of meaning due to the absence of published minimal clinically important differences (MCIDs). Our objective was to determine the MCIDs for improvement in WPAI:SHP in patients with active PsA.MethodsMCIDs for WPAI:SHP domains (presenteeism, work productivity loss, and activity impairment) were derived for patients with active PsA who were biologic naïve or TNF inhibitor (TNFi) experienced using 24-week results from two phase 3 trials (SPIRIT-P1 and SPIRIT-P2). MCIDs were derived using the anchor-based method supplemented by the distribution-based method. Anchors included achievement of the American College of Rheumatology 20 responder index (ACR20), the minimal disease activity (MDA), and the Health Assessment Questionnaire and Disability Index (HAQ-DI) MCID (improvement ≥ 0.35). Anchor validity was assessed by biserial correlation and analysis of covariance modeling against the domains. MCIDs were triangulated using the receiver operating characteristic (ROC) method supplemented by the distribution-based method.ResultsThe analyses included 417 biologic-naïve and 363 TNFi-experienced patients. ACR20, MDA, and HAQ-DI were valid anchors. Significant differences in WPAI:SHP domain scores were observed between patients achieving ACR20, MDA, or HAQ-DI compared to patients not achieving these clinical thresholds (all P < 0.001). ROC analyses suggested that a ≥ 20% improvement in presenteeism, a 15% improvement in work productivity loss, and a 20% improvement in activity impairment represented clinically meaningful improvements in both populations. The distribution-based method supported the results.ConclusionMCIDs for the presenteeism, work productivity loss, and activity impairment domains were estimated to be 20%, 15%, and 20%, respectively, in biologic-naïve or TNFi-experienced PsA populations. These results will help improve the meaningfulness of WPAI:SHP improvements reported by PsA patients.Trial registrationSPIRIT-P1: NCT01695239, SPIRIT-P2: NCT02349295.FundingEli Lilly and Company.

Project description:Background: Findings on the associations between household pet-keeping and allergic diseases, including asthma, rhinitis, and eczema, have been contradictory, with investigations reporting positive, negative, and null associations. This study sought to estimate the prevalence of pet-keeping among families in Kuwait and to assess the associations between pet-keeping and symptoms of allergic diseases among adolescents. Methods: Schoolchildren aged 11-14 years (n = 3,864) were enrolled in this cross-sectional study. The children's parents completed questionnaires regarding their child's environmental exposures, including pet-keeping in the past 12 months, and clinical history and symptoms of allergic diseases. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and their 95% confidence intervals (CIs) were estimated. Results: Pet-keeping in the past 12 months was reported by 42.8% of the participating families. Birds, cats, rabbits, fish, and dogs were kept by 28.3, 13.2, 7.8, 3.9, and 3.1% of all households, respectively. Current cat ownership was significantly associated with current wheezing (aPR 1.29, 95% CI 1.05-1.58), current rhinitis symptoms (aPR 1.18, 95% CI 1.02-1.36), and ever doctor-diagnosed eczema (aPR 1.25, 95% CI 1.03-1.50). Current rabbit-keeping was positively associated with multiple symptoms of asthma (e.g., study-defined current asthma: aPR 1.38, 95% CI 1.04-1.82) and eczema (e.g., severe eczema: aPR 1.94, 95% CI 1.02-3.71). Similarly, current bird-keeping was associated with study-defined current rhinitis (aPR 1.19, 95% CI 1.05-1.41) and current itchy rash (aPR 1.27, 95% CI 1.10-1.46). Conclusions: Household pet-keeping is very common and diverse in Kuwait and was found to be positively associated with symptoms of allergic diseases among adolescents. The findings of associations between rabbit-keeping and symptoms of asthma and eczema add to the existing literature and further highlight the importance of considering the pet type when assessing such associations.

Project description:The purpose of this study was to evaluate the association between oral health and asthma/allergic rhinitis/atopic dermatitis in a large representative Korean adolescent population.A total of 136,027 participants (aged 12-18 years old) were selected from the Korea Youth Risk Behavior Web-based Survey 2014 to 2015. The subjects' history of asthma, allergic rhinitis, and atopic dermatitis was determined by inquiring whether they had been diagnosed by a medical doctor within the previous 12 months or throughout life. Participants were asked if they had experienced the following 6 symptoms regarding oral health in the past 12 months: "chipped or broken tooth," "toothache when eating or drinking," "throbbing and sore tooth," "sore and bleeding gums," "pain in the tongue or inside the cheeks," and "unpleasant breath." The participants were divided into 3 groups according to the number of oral health-related symptoms as follows: good oral health (symptoms = 0), moderate oral health (symptoms = 1), and poor oral health (symptoms = 2-6). Multiple logistic regression analyses calculated the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for asthma/allergic rhinitis/atopic dermatitis within the past 12 months and throughout life among groups with oral health-related symptom groups.Older age, female sex, fewer days of physical activity, lower parental economic level, lower parental education level, smoking, and frequent alcohol consumption were associated with poor oral health (each P < .001). The aORs for asthma/allergic rhinitis/atopic dermatitis were 1.48 (95% CI = 1.34-1.63, P < .001), 1.42 (95% CI = 1.36-1.47, P < .001), and 1.35 (95% CI = 1.28-1.43, P < .001), respectively, in the poor oral health group compared to the good oral health group.Poor oral health was significantly correlated with the prevalence of asthma/allergic rhinitis/atopic dermatitis within the past 12 months and throughout life in Korean adolescents. Based on our comparative data, oral health-related education may be considered to adolescents with allergic disease for good oral health.

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Interaction effects of asthma and rhinitis control on work productivity and activity impairment: A cross-sectional study.

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