Impact of Treatable Traits on Asthma Control and Quality of Life

医学 哮喘 生活质量(医疗保健) 优势比 介绍 恶化 物理疗法 置信区间 儿科 内科学 家庭医学 护理部
作者
Steffi M.J. Janssen,Hanneke A.C. van Helvoort,Tjitske A. Tjalma,Jeanine C. Antons,Remco S. Djamin,Sami O. Simons,Martijn A. Spruit,Alex J. van ‘t Hul
出处
期刊:The Journal of Allergy and Clinical Immunology: In Practice [Elsevier BV]
卷期号:11 (6): 1823-1833.e4 被引量:11
标识
DOI:10.1016/j.jaip.2023.02.034
摘要

Many adult patients with asthma have uncontrolled disease and impaired quality of life, despite current asthma-specific drug therapies.This study aimed to investigate the prevalence of 9 traits in patients with asthma, their associations with disease control and quality of life, and referral rates to nonmedical health care professionals.Retrospectively, data from patients with asthma were collected in 2 Dutch hospitals (Amphia Breda and RadboudUMC Nijmegen). Adult patients without exacerbation <3 months who were referred for a first-ever elective, outpatient, hospital-based diagnostic pathway were deemed eligible. Nine traits were assessed: dyspnea, fatigue, depression, overweight, exercise intolerance, physical inactivity, smoking, hyperventilation, and frequent exacerbations. To assess the likelihood of having poor disease control or decreased quality of life, the odds ratio (OR) was calculated per trait. Referral rates were assessed by checking patients' files.A total of 444 adults with asthma were studied (57% women, age: 48 ± 16 years, forced expiratory volume in 1 second: 88% ± 17% predicted). Most patients (53%) were found to have uncontrolled asthma (Asthma Control Questionnaire ≥1.5 points) and decreased quality of life (Asthma Quality of Life Questionnaire <6 points). Generally, patients had 3.0 ± 1.8 traits. Severe fatigue was most prevalent (60%) and significantly increased the likelihood of having uncontrolled asthma (OR: 3.0, 95% confidence interval [CI]: 1.9-4.7) and decreased quality of life (OR: 4.6, 95% CI: 2.7-7.9). Referrals to nonmedical health care professionals were low; most referrals were to a respiratory-specialized nurse (33%).Adult patients with asthma with a first-ever referral to a pulmonologist frequently exhibit traits justifying the deployment of nonpharmacological interventions, especially in those with uncontrolled asthma. However, referrals to appropriate interventions appeared infrequent.
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