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J. Clin. Med. 2018, 7(12), 471;

Fatigue is Highly Prevalent in Patients with Asthma and Contributes to the Burden of Disease

REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands
Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 ER Maastricht, The Netherlands
Department of Respiratory Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands
Department of Pulmonary Medicine, Radboud University Medical Center (Radboudumc), 6525 GA Nijmegen, The Netherlands
Department of Medical Psychology, Radboudumc, 6525 GA Nijmegen, The Netherlands
Centre of expertise for palliative care, MUMC+, 6229 HX Maastricht, The Netherlands
Department of Medical Psychology, Amsterdam University Medical Centers, location AMC, 1105 AZ Amsterdam, The Netherlands
Member of Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands
Member of Patient Advisory Board, Radboudumc, 6525 GA Nijmegen, The Netherlands
Department of General Practice, MUMC+, 6229 HX Maastricht, The Netherlands
Author to whom correspondence should be addressed.
Received: 26 October 2018 / Revised: 19 November 2018 / Accepted: 21 November 2018 / Published: 23 November 2018
PDF [1410 KB, uploaded 23 November 2018]


The 2018 update of the Global Strategy for Asthma Management and Prevention does not mention fatigue-related symptoms. Nevertheless, patients with asthma frequently report tiredness, lack of energy, and daytime sleepiness. Quantitative research regarding the prevalence of fatigue in asthmatic patients is lacking. This retrospective cross-sectional study of outpatients with asthma upon referral to a chest physician assessed fatigue (Checklist Individual Strength-Fatigue (CIS-Fatigue)), lung function (spirometry), asthma control (Asthma Control Questionnaire (ACQ)), dyspnea (Medical Research Council (MRC) scale), exercise capacity (six-minute walk test (6MWT)), and asthma-related Quality-of-Life (QoL), Asthma Quality of Life Questionnaire (AQLQ) during a comprehensive health-status assessment. In total, 733 asthmatic patients were eligible and analyzed (47.4 ± 16.3 years, 41.1% male). Severe fatigue (CIS-Fatigue ≥ 36 points) was detected in 62.6% of patients. Fatigue was not related to airflow limitation (FEV1, ρ = −0.083); was related moderately to ACQ (ρ = 0.455), AQLQ (ρ = −0.554), and MRC (ρ = 0.435; all p-values < 0.001); and was related weakly to 6MWT (ρ = −0.243, p < 0.001). In stepwise multiple regression analysis, 28.9% of variance in fatigue was explained by ACQ (21.0%), MRC (6.5%), and age (1.4%). As for AQLQ, 42.2% of variance was explained by fatigue (29.8%), MRC (8.6%), exacerbation rate (2.6%), and age (1.2%). Severe fatigue is highly prevalent in asthmatic patients; it is an important determinant of disease-specific QoL and a crucial yet ignored patient-related outcome in patients with asthma. View Full-Text
Keywords: asthma; fatigue; quality of life asthma; fatigue; quality of life

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Van Herck, M.; Spruit, M.A.; Burtin, C.; Djamin, R.; Antons, J.; Goërtz, Y.M.J.; Ebadi, Z.; Janssen, D.J.A.; Vercoulen, J.H.; Peters, J.B.; Thong, M.S.Y.; Otker, J.; Coors, A.; Sprangers, M.A.G.; Muris, J.W.M.; Wouters, E.F.M.; Van ’t Hul, A.J. Fatigue is Highly Prevalent in Patients with Asthma and Contributes to the Burden of Disease. J. Clin. Med. 2018, 7, 471.

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