A recent multicentre study confirms that anxiety and depression are independent risk factors for poor asthma control. A novel finding is that under specialist supervision, there were significantly improved levels of anxiety and depression, asthma control, and pulmonary function.
Joaquín Sastre, primer firmante del estudio. /UAM
Anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control.
"The study aimed to explore the relationship between asthma control and these 2 psychological disorders in a Spanish population, and also to measure changes over a 6-month period of specialist treatment according to standardized asthma guidelines", said the first author of the study, Dr. Joaquín Sastre, professor of the School of Medicine of UAM.
The study was carried out by 180 spanish pulmonologist and allergologist coordinated by physicians from Universidad Autónoma de Madrid (UAM), Fundación Jiménez Díaz de Madrid and Hospital de la Santa Creu y Sant Pau. The study was founded by an unrestricted grant from Mundipharma Spain and published in the The Journal of Allergy and Clinical Immunology in Practice.
3182 patients with moderate to severe asthma were enrolled. All were evaluated with pulmonary function tests and different standardized scales to measure asthma control, anxiety and depression at baseline and at 6 months. Treatments were decided by specialists according to published guidelines.
At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively. The overall prevalence of anxiety was higher among adults with moderate to severe asthma compared with the general population in Spain, where the prevalence is 9.4%. However, depression prevalence was similar to that in the general population in Spain (11.5%) . As a novel contribution, investigators described that after 6 months of treatment , anxiety and depression significantly improved, more patients had well-controlled asthma, severe asthma was less prevalent and an improvement in pulmonary function tests had occurred. Patients that during the study presented more anxiety and depression used significantly more health care resources and had more asthma exacerbations.
INFLUENCE ON ASTHMA CONTROL
A complex statistical analysis showed that patients with anxiety, depression, and with lower function tests were independently associated with poor asthma control. Anxiety had a nearly 4-fold greater influence over asthma control than depression.
In summary, in patients with moderate to severe asthma, regular specialist care improves many asthma outcomes as asthma symptoms, pulmonary function and use of health care resources, frequently affecting these patients, including symptoms of anxiety and depression.
References:
MSastre J, et al. 2018. Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment. J Allergy Clin Immunol Pract. DOI: 10.1016/j.jaip.2018.02.002
