Health-related quality of life assessment using St. George's respiratory questionnaire in asthmatics on inhaled corticosteroids

CONTEXT: Chronic diseases like asthma have significant effects on patients’ health-related quality of life (HRQoL). HRQoL measures additional indices as compared to objective measurements like spirometry. AIMS: To assess and compare disease-specific quality of life in asthma patients using St. George's Respiratory Questionnaire (SGRQ) receiving fluticasone, beclomethasone, and budesonide (BUD). SETTINGS AND DESIGN: A prospective, open label, randomized, parallel group study conducted at a tertiary care teaching hospital in South India. MATERIALS AND METHODS: A 6-month follow-up of 277 patients with mild, moderate, and severe persistent asthma was randomized to receive fluticasone propionate (FP), BUD, or beclomethasone dipropionate (BDP) in equipotent doses according to their global initiative on asthma (GINA) severity. Statistical analysis used: Data analyzed using SPSS version: 13.0. General linear-repeated measures using the post-hoc bonferroni method assessed significance between treatment groups. RESULTS: Significant decrease (P < 0.05) in each SGRQ domains and total scores as well as improvement in FEV(1) (P < 0.05) was observed in all study subjects. A significant early response (P < 0.05) was noted after 15 days treatment in patients receiving FP with respect to SGRQ (activity, impact and total) scores and dyspnea indices, but not FEV(1). This improvement with FP was due to its greater effect in patients with moderate and severe persistent asthma. No difference was noted subsequently in all outcome measures studied until 6 months. CONCLUSIONS: There was evidence for an early QoL improvement to FP as compared to BUD or BDP in moderate and severe persistent asthma. Subsequently, the three ICS showed similar improvements in lung functions and dyspnea indices throughout the study.