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Terry D, Peck B, Kloot K. Paediatric Emergency Asthma Presentations: Temporal Trends and Representations in Rural Australia. Healthcare (Basel) 2023; 11:3113. [PMID: 38132002 PMCID: PMC10742987 DOI: 10.3390/healthcare11243113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Asthma is a key illness driving children to present to emergency departments, and although paediatric emergency asthma presentations have been examined, the temporal trends remain somewhat elusive. The aim is to highlight, describe, and model the temporal trends of emergency paediatric asthma presentations, using comprehensive hospital emergency presentation data. A retrospective cross-sectional study examined de-identified paediatric (0 to 14 years) emergency asthma presentation data over a three-year period. Data were obtained from nine healthcare facilities in Victoria, Australia. Episode-level data were collected through RAHDaR, a comprehensive emergency data register which includes missing data (35.0%) among rural health facilities not currently captured elsewhere. Monthly presentation rates demonstrate a significant difference in presentations between fall/autumn and spring, and males had higher presentation rates in February and June-August. Emergency presentations were more likely to occur Sunday-Tuesday, peaking in the time periods of 8-9 a.m., 11 a.m.-12 p.m., and 8-9 p.m. Significant differences were noted between all age groups. Examining previously unavailable rural data has highlighted patterns among emergency asthma presentations for children 0-14 years of age. Knowledge of these by season, month, and day of the week, in combination with time of day, offers scope for more focused workforce education and planning, and nuanced referral pathways, particularly in resource-limited settings.
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Affiliation(s)
- Daniel Terry
- School of Nursing and Midwifery, University of Southern Queensland, Ipswich, QLD 4305, Australia;
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC 3350, Australia;
| | - Blake Peck
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC 3350, Australia;
| | - Kate Kloot
- School of Medicine, Deakin University, Warrnambool, VIC 3280, Australia
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Mahony T, Harder VS, Ang N, McCulloch CE, Shaw JS, Thombley R, Cabana MD, Kleinman LC, Bardach NS. Weekend Versus Weekday Asthma-Related Emergency Department Utilization. Acad Pediatr 2022; 22:640-646. [PMID: 34543671 DOI: 10.1016/j.acap.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/09/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess variation in asthma-related emergency department (ED) use between weekends and weekdays. METHODS Cross-sectional administrative claims-based analysis using California 2016 Medicaid data and Vermont 2016 and Massachusetts 2015 all-payer claims databases. We defined ED use as the rate of asthma-related ED visits per 100 child-years. A weekend visit was a visit on Saturday or Sunday, based on date of ED visit claim. We used negative binomial regression and robust standard errors to assess variation between weekend and weekday rates, overall and by age group. RESULTS We evaluated data from 398,537 patients with asthma. The asthma-related ED visit rate was slightly lower on weekends (weekend: 18.7 [95% confidence interval (CI): 18.3-19.0], weekday: 19.6 [95% CI, 19.3-19.8], P < .001). When stratifying by age group, 3- to 5-year-olds had higher rates of asthma-related ED visits on weekends than weekdays (weekend: 33.7 [95% CI, 32.6-34.7], weekday: 29.8 [95% CI, 29.1-30.5], P < .001) and 12- to 17-year-olds had lower rates of ED visits on weekends than weekdays (weekend: 13.0 [95% CI: 12.5-13.4], weekday: 16.3 [95% CI: 15.9-16.7], P < .001). In the other age groups (6-11, 18-21 years) there were not statistically significant differences between weekend and weekday rates (P > .05). CONCLUSIONS In this multistate analysis of children with asthma, we found limited overall variation in pediatric asthma-related ED utilization on weekends versus weekdays. These findings suggest that increasing access options during the weekend may not necessarily decrease asthma-related ED use.
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Affiliation(s)
- Talia Mahony
- Department of Pediatrics, University of California, San Francisco (T Mahony and NS Bardach)
| | - Valerie S Harder
- Department of Pediatrics, Larner College of Medicine, University of Vermont (VS Harder and JS Shaw), Burlington, Vt
| | - Nikkolson Ang
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (N Ang, R Thombley, and NS Bardach)
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco (CE McCulloch)
| | - Judith S Shaw
- Department of Pediatrics, Larner College of Medicine, University of Vermont (VS Harder and JS Shaw), Burlington, Vt
| | - Robert Thombley
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (N Ang, R Thombley, and NS Bardach)
| | - Michael D Cabana
- Department of Pediatrics, Albert Einstein College of Medicine (MD Cabana), Bronx, NY; Children's Hospital at Montefiore (MD Cabana), Bronx, NY
| | - Lawrence C Kleinman
- Rutgers Robert Wood Johnson School of Medicine (LC Kleinman), New Brunswick, NJ
| | - Naomi S Bardach
- Department of Pediatrics, University of California, San Francisco (T Mahony and NS Bardach); Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (N Ang, R Thombley, and NS Bardach).
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Shi L, Liang D, Gao Y, Huang J, Nolan C, Mulvaney A, Poole T, Zhang H. Mindfulness and asthma symptoms: A study among college students. J Asthma 2017; 55:101-105. [PMID: 28459349 DOI: 10.1080/02770903.2017.1306545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Given the known link between asthma and stress as well as the link between mindfulness and stress, we explore the possible association between trait mindfulness and asthma-related diagnosis and symptoms with a cross-sectional study. METHOD In 2014, we surveyed a sample of college students in their freshman year, from a public university in Shanghai, China. We used three multilevel logistic regressions to estimate the association between trait mindfulness (measured by Mindful Awareness Attention Scale, MAAS) and self-report of ever having an asthma diagnosis, ever having had persistent dry cough, and ever having had wheezing symptoms. Age, gender, household registration status, and the frequency of smog in the respondent's hometown were used as control variables in the study. The home province of the student was used as the cluster variable in the multilevel models. RESULTS Among the 1392 students in the analysis sample (mean age = 18.3), 47 (3.4%) self-reported an asthma diagnosis, 251 (18.1%) reported having had persistent dry cough, and 100 (7.2%) reported having had wheezing symptoms. A one-unit increase in MAAS is negatively associated with having a self-reported asthma diagnosis (Odds Ratio (OR): 0.662, 95% Confidence Interval (CI): 0.452, 0.969, p = 0.034), having had persistent dry cough (OR: 0.658, 95% CI: 0.545, 0.795, p < 0.001), and wheezing (OR = 0.747, 95% CI: 0.569, 0.981, p = 0.036). DISCUSSION This is the first study to suggest a link between trait mindfulness and asthma. Our finding provides evidence that people with higher level of mindfulness are less likely to have had an asthma diagnosis and less likely to have the symptoms of persistent dry cough and wheezing.
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Affiliation(s)
- Lu Shi
- a Department of Public Health Sciences , Clemson University , Clemson , SC , USA
| | - Di Liang
- b Department of Health Policy and Management , University of California Los Angeles , Los Angeles , CA , USA
| | - Yu Gao
- c Department of Physical Education , Shanghai University of Finance and Economics , Shanghai , China
| | - Jiayan Huang
- d Health Policy and Management , Fudan University , Shanghai , China
| | - Cameron Nolan
- a Department of Public Health Sciences , Clemson University , Clemson , SC , USA
| | - Andrew Mulvaney
- a Department of Public Health Sciences , Clemson University , Clemson , SC , USA
| | - Taryn Poole
- e Department of Biological Sciences , Clemson University , Clemson , SC , USA
| | - Hailin Zhang
- f Department of Pediatrics , Wenzhou Medical University , Wenzhou , China
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Reinberg AE, Dejardin L, Smolensky MH, Touitou Y. Seven-day human biological rhythms: An expedition in search of their origin, synchronization, functional advantage, adaptive value and clinical relevance. Chronobiol Int 2016; 34:162-191. [DOI: 10.1080/07420528.2016.1236807] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Alain E. Reinberg
- Unité de Chronobiologie, Fondation Adolphe de Rothschild, Paris Cedex, France
| | - Laurence Dejardin
- Unité de Chronobiologie, Fondation Adolphe de Rothschild, Paris Cedex, France
- Hôpital Français Saint Louis, Jerusalem, Israel
| | - Michael H. Smolensky
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Yvan Touitou
- Unité de Chronobiologie, Fondation Adolphe de Rothschild, Paris Cedex, France
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Ismaila AS, Sayani AP, Marin M, Su Z. Clinical, economic, and humanistic burden of asthma in Canada: a systematic review. BMC Pulm Med 2013; 13:70. [PMID: 24304726 PMCID: PMC4235031 DOI: 10.1186/1471-2466-13-70] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 11/28/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Asthma, one of the most common chronic respiratory diseases, affects about 3 million Canadians. The objective of this study is to provide a comprehensive evaluation of the published literature that reports on the clinical, economic, and humanistic burden of asthma in Canada. METHODS A search of the PubMed, EMBASE, and EMCare databases was conducted to identify original research published between 2000 and 2011 on the burden of asthma in Canada. Controlled vocabulary with "asthma" as the main search concept was used. Searches were limited to articles written in English, involving human subjects and restricted to Canada. Articles were selected for inclusion based on predefined criteria like appropriate study design, disease state, and outcome measures. Key data elements, including year and type of research, number of study subjects, characteristics of study population, outcomes evaluated, results, and overall conclusions of the study, were abstracted and tabulated. RESULTS Thirty-three of the 570 articles identified by the clinical and economic burden literature searches and 14 of the 309 articles identified by the humanistic burden literature searches met the requirements for inclusion in this review. The included studies highlighted the significant clinical burden of asthma and show high rates of healthcare resource utilization among asthma patients (hospitalizations, ED, physician visits, and prescription medication use). The economic burden is also high, with direct costs ranging from an average annual cost of $366 to $647 per patient and a total annual population-level cost ranging from ~ $46 million in British Columbia to ~ $141 million in Ontario. Indirect costs due to time loss from work, productivity loss, and functional impairment increase the overall burden. Although there is limited research on the humanistic burden of asthma, studies show a high (31%-50%) prevalence of psychological distress and diminished QoL among asthma patients relative to subjects without asthma. CONCLUSIONS As new therapies for asthma become available, economic evaluations and assessment of clinical and humanistic burden will become increasingly important. This report provides a comprehensive resource for health technology assessment that will assist decision making on asthma treatment selection and management guidelines in Canada.
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Affiliation(s)
- Afisi S Ismaila
- Medical Affairs, GlaxoSmithKline Canada, Mississauga, ON, Canada
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Amyn P Sayani
- Medical Affairs, GlaxoSmithKline Canada, Mississauga, ON, Canada
| | - Mihaela Marin
- Product Value Strategy Consulting, Optum, Burlington, Ontario, Canada
| | - Zhen Su
- Medical Affairs, Sanofi, Cambridge, MA, USA
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Park M, Luo S, Kwon J, Stock TH, Delclos G, Kim H, Yun-Chul H. Effects of Air Pollution on Asthma Hospitalization Rates in Different Age Groups in Metropolitan Cities of Korea. AIR QUALITY, ATMOSPHERE, & HEALTH 2013; 6:10.1007/s11869-013-0195-x. [PMID: 24223075 PMCID: PMC3821782 DOI: 10.1007/s11869-013-0195-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Many studies have shown associations between air pollution and asthma admissions in Korea, but have not reported whether these effects differ by age classification. The purpose of this study was to determine whether air pollution effects on asthmatic hospital admissions are different by three age groups (years): children (less than 15), adults (15-64; reference group), and the elderly (over 65). Daily time-series data from seven metropolitan cities in South Korea were analyzed in two stages. In the first stage, relative asthma morbidity rates associated with air pollution were estimated for each city and age group, using semi-parametric log-linear regression. In the second stage, estimates from all seven cities were combined by age group using Bayesian hierarchical modeling. The effects of exposure to particulate matter <10 micrometers in aerodynamic diameter (PM10), carbon monoxide (CO) and nitrogen dioxide (NO2) varied significantly by age groups. Using adults as the referent, the relative rate (RR) of asthma admissions with 10μg/m3 increase of PM10 is 1.5% (95%CI: 0.1-2.8%) lower for children, and 1.3% (95% CI: 0.7-1.9%) higher for the elderly; RR with 1ppm increase of CO is 1.9% (95% CI: 0.3-3.8%) lower for children; RR with 1ppb increase of NO2(1ppb) is 0.5% (95% CI: 0.3-0.7%) higher for the elderly. No significant age group difference in relative rate was found for ozone or sulfur dioxide.
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Canova C, Heinrich J, Anto JM, Leynaert B, Smith M, Kuenzli N, Zock JP, Janson C, Cerveri I, de Marco R, Toren K, Gislason T, Nowak D, Pin I, Wjst M, Manfreda J, Svanes C, Crane J, Abramson M, Burr M, Burney P, Jarvis D. The influence of sensitisation to pollens and moulds on seasonal variations in asthma attacks. Eur Respir J 2013; 42:935-45. [PMID: 23471350 PMCID: PMC3787817 DOI: 10.1183/09031936.00097412] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
No large study has described the seasonal variation in asthma attacks in
population-based asthmatics in whom sensitisation to allergen has been
measured. 2637 young adults with asthma living in 15 countries reported the months in which
they usually had attacks of asthma and had skin-prick tests performed.
Differences in seasonal patterns by sensitisation status were assessed using
generalised estimating equations. Most young adults with asthma reported periods of the year when their asthma
attacks were more common (range: 47% in Sweden to 86% in
Spain). Seasonal variation in asthma was not modified by sensitisation to
house dust mite or cat allergens. Asthmatics sensitised to grass, birch and
Alternaria allergens had different seasonal patterns to
those not sensitised to each allergen, with some geographical variation. In
southern Europe, those sensitised to grass allergens were more likely to report
attacks occurred in spring or summer than in winter (OR March/April 2.60,
95% CI 1.70–3.97; OR May/June 4.43, 95% CI
2.34–8.39) and smaller later peaks were observed in northern Europe
(OR May/June 1.25, 95% CI 0.60–2.64; OR July/August 1.66,
95% CI 0.89–3.10). Asthmatics reporting hay fever but who were
not sensitised to grass showed no seasonal variations. Seasonal variations in asthma attacks in young adults are common and are
different depending on sensitisation to outdoor, but not indoor, allergens. Seasonal variation in asthma attacks is associated with sensitisation to
pollens and moulds, but not indoor allergenshttp://ow.ly/nsuRS
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Lee CC, Sheridan SC, Lin S. Relating weather types to asthma-related hospital admissions in New York State. ECOHEALTH 2012; 9:427-439. [PMID: 23224756 DOI: 10.1007/s10393-012-0803-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 10/08/2012] [Accepted: 10/16/2012] [Indexed: 06/01/2023]
Abstract
Many previous studies have looked into the relationship between asthma and individual weather variables, but comparatively few have looked at this relationship using holistic weather types (WTs). Utilizing the Spatial Synoptic Classification, this research considers up to 6 days of lag time while investigating the asthma-to-WT relationship in two age groups (under 18 and 18 and over) throughout New York State. Results indicate that a cold and dry WT in autumn corresponds to increased asthma admissions and spike days in admissions in New York City (NYC) for the school-aged population, while hot and dry WTs in summer correspond to spike days in asthma admissions in both age groups. However, results vary considerably for other regions, seasons and WTs, and spike day analysis yields clearer results than the analysis of total anomalous admissions. When stratified by multiple regions and age groups, the sample size of daily asthma admissions is a limiting factor outside of NYC.
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Melero Moreno C, López-Viña A, García-Salmones Martín M, Cisneros Serrano C, Jareño Esteban J, Ramirez Prieto MT. Factors Related With the Higher Percentage of Hospitalizations Due to Asthma Amongst Women: The FRIAM Study. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.arbr.2012.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Factors related with the higher percentage of hospitalizations due to asthma amongst women: the FRIAM study. Arch Bronconeumol 2012; 48:234-9. [PMID: 22475519 DOI: 10.1016/j.arbres.2012.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 02/03/2012] [Accepted: 02/12/2012] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The reason why there is a higher hospitalization rate due to asthma exacerbations amongst women is unclear. The objective of this study is to explore the possible causes that may explain this fact. METHODS A multi-center, prospective study including asthma patients hospitalized in the pulmonary medicine departments during a two-year period. By means of a questionnaire, the following data were collected: demographic characteristics and treatment compliance, anxiety-depression, hyperventilation and asthma control, both prior to and during the hospitalization. RESULTS 183 patients were included, 115 (62.84%) of whom were women. The women were older (52.4 ± 18.3/43.4 ± 18.7; P=.02), were more frequently prescribed inhaled corticosteroids (63.2%/47.1%; P=.03) and had a higher rate of hyperventilation syndrome (57.3/35.9; P=.02) and a longer mean hospital stay (7.3 ± 3.4/5.9 ± 3.6; P=.02). The percentage of smokers among the women was lower (21.2%/38.8%; p=0.01) and the FEV(1) was lower at admittance (58.2% ± 15.9/67.5% ± 17.4; P=.03). In the 40 to 60-year-old age range, an association was demonstrated between being female and the 'previous hospitalizations' variable (OR, 16.1; 95% CI, 1.6-156.7); sex and obesity were also independently associated (OR, 4.8; 95% CI, 1.06-22). CONCLUSIONS In this cohort, the rate of hospitalization for asthma was higher in women than in men. Being a woman between the ages of 40 and 60 is associated with previous hospitalizations and is a risk factor for asthma-related hospitalization. This situation could partially be explained by the hormonal changes during menopause, where polyposis and obesity are independent risk factors.
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Kawasumi Y, Abrahamowicz M, Ernst P, Tamblyn R. Development and validation of a predictive algorithm to identify adult asthmatics from medical services and pharmacy claims databases. Health Serv Res 2011; 46:939-63. [PMID: 21275988 PMCID: PMC3097410 DOI: 10.1111/j.1475-6773.2010.01235.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To develop and validate the accuracy of a predictive model to identify adult asthmatics from administrative health care databases. STUDY SETTING An existing electronic medical record project in Montreal, Quebec. STUDY DESIGN One thousand four hundred and thirty-one patients with confirmed asthma status were identified from primary care physician's electronic medical record. DATA COLLECTION/EXTRACTION METHODS Therapeutic indication of asthma in an electronic prescription and/or confirmed asthma from an automated problem list were used as the gold standard. Five groups of asthma-specific markers were identified from administrative health care databases to estimate the probability of the presence of asthma. Cross-validation evaluated the diagnostic ability of each predictive model using 50 percent of sample. PRINCIPAL FINDINGS The best performance in discriminating between the patients with asthma and those without it included indicators from medical service and prescription claims databases. The best-fitting algorithm had a sensitivity of 70 percent, a specificity of 94 percent, and positive predictive value of 65 percent. The prescriptions claims-specific algorithm demonstrated a nearly equal performance to the model with medical services and prescription claims combined. CONCLUSIONS Our algorithm using asthma-specific markers from administrative claims databases provided moderate sensitivity and high specificity.
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Affiliation(s)
- Yuko Kawasumi
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, Vancouver, BC, Canada.
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Velthove KJ, Bracke M, Souverein PC, Schweizer RC, Ten Berg MJ, Leufkens HGM, van Solinge WW. Identification of exacerbations in obstructive lung disease through biomarkers. Biomarkers 2010; 14:523-8. [PMID: 19863191 DOI: 10.3109/13547500903150763] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Inflammation has been identified as an important factor for disease exacerbation in obstructive lung disease. In this study, we used neutrophil and eosinophil counts as biomarkers for exacerbation in obstructive lung disease. We conducted a case-control study within a cohort of patients frequenting an outpatient clinic of Respiratory Medicine using data from the Utrecht Patient Oriented Database (UPOD). Cases were patients with a hospital admission for obstructive lung disease in 2005. For each case, one control patient was sampled from the same study base. We identified 143 cases (118 patients with chronic obstructive pulmonary disease and 25 asthma patients) and 143 controls. Admission was associated with both neutrophilia (adjusted odds ratio (OR) 4.3; 95% confidence interval (CI) 2.2-8.5), and eosinophilia (adjusted OR 2.6; 95% CI 1.1-6.2). The association with eosinophilia was only seen in asthma patients. In conclusion, neutrophil and eosinophil counts seem to be useful biomarkers for identifying exacerbations in pharmacoepidemiological studies on obstructive lung disease.
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Affiliation(s)
- Karin J Velthove
- Faculty of Science, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, The Netherlands
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Temprano J, Mannino DM. The effect of sex on asthma control from the National Asthma Survey. J Allergy Clin Immunol 2009; 123:854-60. [PMID: 19181370 DOI: 10.1016/j.jaci.2008.12.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Revised: 12/04/2008] [Accepted: 12/11/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Previous studies have demonstrated conflicting results with regard to differences in asthma control between the sexes. OBJECTIVE We sought to identify sex differences in short-term and long-term measures of asthma control in adults from the National Asthma Survey. METHODS This study analyzed data from the National Asthma Survey (Four-State sample) sponsored by the National Center for Environmental Health, Centers for Disease Control and Prevention. Asthma control was compared between the sexes based on short-term (recent symptoms, asthma attacks, and albuterol use) and long-term (asthma attacks, work days lost, and urgent-care visits and hospitalizations in the prior year) measures. Composite scores for short-term and long-term control were calculated based on any single measure of poor asthma control and based on a sum of poor asthma control measures. RESULTS Women were more likely to have poor short-term asthma control based on any measure (adjusted odds ratio [OR], 1.20; CI, 1.01-1.44) or sum of measures (adjusted OR, 1.24; CI, 1.08-1.53) compared with men. Women also demonstrated worse asthma control based on any uncontrolled long-term measure (adjusted OR, 1.52; CI, 1.29-1.79) or sum of measures (adjusted OR, 1.68; CI, 1.45-1.93). These findings were present despite higher reported inhaled corticosteroid use and scheduled health care visits for asthma among women. CONCLUSIONS Women demonstrated worse asthma control compared with men with regard to several short-term and long-term measures, despite reporting higher rates of inhaled corticosteroid use and routine asthma care visits. Further studies are needed to elucidate whether these findings are due to differences in health reporting or to pathophysiologic differences in asthma between the sexes.
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Affiliation(s)
- James Temprano
- Department of Internal Medicine, Division of Allergy and Immunology, University of Kentucky, Lexington, KY 40508, USA.
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