Health-Related Quality of Life Varies in Different Respiratory Disorders

A Multi-case Control Population Based Study

Veronica Cappa; Alessandro Marcon; Gianfranco Di Gennaro; Liliya Chamitava; Lucia Cazzoletti; Cristina Bombieri; Morena Nicolis; Luigi Perbellini; Silvia Sembeni; Roberto de Marco; Francesco Spelta; Marcello Ferrari; Maria Elisabetta Zanolin


BMC Pulm Med. 2019;19(32) 

In This Article


In chronic illnesses, Health-related Quality of Life (HRQL, which daily activities people can perform and how they feel) is a primary concern and is often used as the outcome in both clinical trials and observational studies.[1] In addition, as people generally seek health care only when they feel unhealthy, self-perception of health is a predictive of the future burden on the health care delivery system.[2,3]

Asthma is a critical public health problem worldwide, affecting people of all ages and both sexes.[4,5] It impairs school and work performance[6] as well as physical and mental quality of life.[3,4,7]

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation, associated with an enhanced chronic inflammatory response in the airways and the lungs to noxious particles or gases. Frequently, patients suffering from COPD have impaired daily activities, often in association with symptoms of dyspnea and fatigue.[8,9] Also subjects with chronic bronchitis (CB) may present poor mental health.[10–12] Rhinitis is an inflammation of the lining of the nose and is characterized by nasal symptoms, including rhinorrhea, sneezing, nasal blockage and/or itching of the nose.[13] Allergic rhinitis (AR), a symptomatic disorder of the nose induced after allergen exposure, may be associated with daily activities reduction.[14] In addition, having an allergic reaction could cause significant fatigue and mood changes,[15] impairment of cognitive functions[16,17] depression, and anxiety.[18,19] Although HRQL has been frequently assessed in subjects with AR,[15,19] there is a lack of epidemiological studies on non-allergic rhinitis (NAR),[20] especially on the quality of life of people suffering from it.

Subjects suffering from AR commonly have current asthma (CA) and the effect of AR alone cannot be disentangled. Therefore, it can be of interest to analyse the role of AR in subjects without asthma.

HRQL in respiratory diseases has been mainly investigated in a clinical setting, where usually subjects have a worse condition with respect to general population and, as a consequence, present a HQRL that does not correspond to real life.[17,20–22] Moreover, most of previous studies focused on a single disorder, losing the chance to analyze the relative weight of the different respiratory disorders.

In the frame of the Gene Environment Interactions in Respiratory Diseases (GEIRD) survey, a multicase-control study in the general population, the aim of this paper was to assess the relationship between HRQL and COPD, asthma, CB, and rhinitis considered simultaneously.