Presenteeism in Severe Asthma Treated by Biotherapyasthma

University Hospital, Lille174 enrolled

Overview

Severe asthma is a condition characterized by a lower sensitivity to high doses of inhaled corticosteroids combined with a second controller, most often a long-acting bronchodilator. It concerns approximately 5% of asthmatics. Treatment failure and co-morbidities induced by systemic corticosteroid therapy can cause debilitating dyspnea, limited physical activity, and impaired quality of life. Severe asthma could therefore be associated with major presenteeism, defined as the presence of an employee at work despite his health issues and which implies a limitation of the employee's productive capacity. Uncontrolled asthma and co-morbidities of asthma have been shown to be associated with a decrease in work productivity that includes absenteeism and presenteeism. Although there is little data, a recent study found a decline in work productivity in severe asthma. Various factors associated with presenteeism could be involved, such as asthma control, frequency and severity of exacerbations, comorbidities, or treatments. Biotherapies targeting the signaling pathways involved in airway inflammation improve asthma control, decrease the frequency of asthma exacerbations which are major determinants of quality of life, improve lung function, and allow oral steroid sparing. Biotherapies could therefore be associated with a decrease in presenteeism. The objective of the study is to describe the evolution of presenteeism at work, evaluated by the WPAI: Asthma, after 6 months of treatment by biotherapy and to identify factors associated with this evolution

Study Type

OBSERVATIONAL

Enrollment

174

Conditions

Asthma

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Severe asthma defined as the use of a high doses of inhaled corticosteroids combined with a second controller (GINA 4) and / or oral corticosteroid therapy \> 50% of the year * Eligible for biotherapy according to the investigator's decision * Holders of an employment contract for at least 8 days * Written non-opposition to participate in the study after information * Social protection affiliation Exclusion Criteria: * Existence of another chronic pulmonary disease (bronchiectasis, COPD, diffuse interstitial lung disease, neuromuscular pathology, etc.) or cardiac (cardiac rhythm disorder, ischemic heart disease, etc.) significant according to the investigator's judgment * Psychiatric disorder * Pregnancy * Persons under guardianship

Outcomes

Primary Outcomes

Change in presenteeism

Change Questionnaire Work Productivity and activity impairment : Asthma (WPAI : Asthma) - question 5 (Q5) after 6 months of biotherapy The WPAI-question 5 ranges from 0 to 10, a higher score meaning a worse outcome

Time frame: At 6 months

Secondary Outcomes

Correlation between the WPAI : Asthma- Q5 score and the ACQ-6 score

Association between presenteeism and asthma control Asthma Control Questionnaire (ACQ) is simple questionnaire to measure the adequacy of asthma control and change in asthma control, 7-point scale (0=no impairment, 6= maximum impairment for symptoms and rescue use; and 7 categories for FEV1%)

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the mMRC score

Association between presenteeism and exercise dyspnea at baseline the mMRC (Modified Medical Research Council) Dyspnea Scale,The 1-5 stage scale is used alongside the questionnaire to establish clinical grades of breathlessness.

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and FEV1, la FVC and RV.

Association between presenteeism and airways obstruction at baseline

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the STAI-Y2 score

Association between presenteeism and anxiety at baseline tate-Trait Anxiety Inventory, STAI-Y2 (STAI-Y2), consists of 20 sentences assessing the subject's usual emotional state.Each answer to an item in the STAI-Y is scored from 1 to 4, with 1 indicating the lowest degree of anxiety and 4 the highest degree of anxiety.

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the Nijmegen score

Association between presenteeism and hyperventilation symptoms at baseline

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the SNOT-22 score

Association between presenteeism and sino-nasal symptoms at baseline

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the AQLQ score

Association between presenteeism and quality of life at baseline

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the daily dose of oral corticosteroids

Association between presenteeism and daily dose of oral corticosteroids at baseline

Time frame: at baseline

Correlation between the WPAI : Asthma- Q5 score and the cumulative dose over 6 months of oral corticosteroids

Association between presenteeism and cumulative dose over 6 months of oral corticosteroids at baseline

Time frame: at baseline

Correlation between the change in the WPAI : Asthma- Q5 score and in the ACQ-6 score

Association between the change in presenteeism and in asthma control after 6 months of biotherapy