The clinical benefit of evaluating health-related quality-of-life in children with problematic severe asthma

Aim: To evaluate health‐related quality‐of‐life (HR‐QoL) and the asthma control test (ACT) in children with problematic severe asthma and those with controlled asthma and to identify whether clinical characteristics show correlations with these measurements. Methods: This multicentre cross‐sectional study included 93 children in total, 54 with problematic severe asthma and 39 age‐matched with controlled asthma. Subjects completed the Paediatric Asthma Quality‐of‐Life Questionnaire as well as a standardized health questionnaire and the ACT. Objective measurements of exhaled nitric oxide, specific sensitization, pulmonary function and bronchial hyper‐responsiveness to methacholine were also taken. Results: HR‐QoL was reduced in children with problematic severe asthma (5.4 vs. 6.7, p < 0.001), particularly for girls (5.1 vs. 5.6 for boys, p = 0.02), and their ACT scores were also lower (17 vs. 23, p < 0.001) compared with those of subjects with controlled asthma. A HR‐QoL score <6.2 discriminated problematic severe asthma from controlled asthma with 85% sensitivity and 97% specificity, as did the ACT score <20 (79% sensitivity and 94% specificity). Objective measures and other clinical characteristics were weakly associated with HR‐QoL or ACT score. Conclusion: Subjective measurements of HR‐QoL and asthma control are both equally useful in differentiating children with problematic severe asthma from those with controlled asthma.