Quality of Life Suffers When Exercise Brings on Asthma Symptoms

Megan Brooks

April 01, 2011

April 1, 2011 (San Francisco, California) — Quality of life suffers when children and adults with asthma experience exercise-induced bronchospasm (EIB), according to results of a survey presented here at the American Academy of Allergy, Asthma and Immunology (AAAAI) 2011 Annual Meeting.

EIB can be "very frustrating; the people in the survey with EIB were often frustrated with their ability to exercise, to participate in sports, and to keep in shape," Timothy J. Craig, DO, from Penn State Hershey Allergy and Immunology in Hershey, Pennsylvania, noted in an interview with Medscape Medical News.

"A good portion of those with exercise-related respiratory symptoms," he added, "didn't know they should use albuterol before they exercise to try to decrease their symptoms during exercise."

EIB Landmark Survey

The EIB Landmark Survey is the first comprehensive survey focusing on exercise-related respiratory symptoms in the United States, according to Dr. Craig and his colleagues involved in the survey. Although exercise is widely recognized as a common trigger for asthma symptoms, "relatively little attention has been paid in the past to the burden of disease represented by exercise-induced bronchospasm," they point out.

At the AAAAI's annual gathering, Dr. Craig reported on 1001 adults and 516 children with asthma who participated in the survey and provided information on their quality of life with regard to asthma and EIB symptoms.

The survey found that 4 out of 5 patients with current asthma reported 1 or more symptoms of EIB during or after sports, exercise, play, or other physical activity. Quality of life was compromised to a greater extent in those with EIB symptoms than in those without EIB symptoms.

Roughly 30% reported that EIB symptoms interfered "a lot" or "moderately" with their daily life. Compared with those without EIB, twice as many respondents with EIB (roughly 40%) reported that they "cannot keep up as well as others their own age in physical activities," the researchers note in a meeting abstract.

Emotional disturbances were 2 to 4 times more common in those with EIB. EIB caused 52% to be frustrated, 25% to be fearful, and 20% to be depressed or embarrassed.

EIB also creates a burden for society. The numbers of sick days taken, hospitalizations, emergency department visits, and other unscheduled emergency healthcare visits were higher for asthma patients with exercise-related symptoms than for those with asthma but no exercise-related symptoms.

Instruct Patients With EIB to Plan Ahead

Relatively few patients with EIB symptoms said they regularly use their quick-relief inhaler prophylactically before exercise or vigorous physical activity to avoid symptoms. Most used it during or after exercise.

Patients with EIB, Dr. Craig said, "need to be more diligently managed. I encourage my patients to take 2 puffs of albuterol before exercise, despite their maintenance therapy."

"One of the arguments for this," Dr. Craig said, "is that you don't want people to get frustrated and then not exercise, gain weight, and become more frustrated. To avoid this vicious cycle, you want to make sure they stay well controlled at all times."

Reached for comment, Rebecca G. Piltch, MD, who was not involved in the survey, said the EIB Landmark Survey data "are not that surprising."

She noted that quality of life "has been recognized as important" in patients with asthma and allergies and that "tools such as the Juniper Asthma Quality of Life Questionnaire are a welcome addition to a clinician's armamentarium." Dr. Piltch has a private practice in San Francisco, California, specializing in allergy, asthma, and immunology care for infants, children, and adults.

The survey was conducted by the public opinion research organization Abt SRBI, in partnership with Strategic Pharma Solutions, and sponsored by Teva Respiratory. Dr. Craig is a paid consultant for Teva Respiratory. Dr. Piltch has disclosed no relevant financial relationships.

American Academy of Allergy, Asthma and Immunology (AAAAI) 2011 Annual Meeting: Abstract 563. Presented March 20, 2011.


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