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McLoughlin RF, McDonald VM. The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma. FRONTIERS IN ALLERGY 2022; 2:735030. [PMID: 35387051 PMCID: PMC8974714 DOI: 10.3389/falgy.2021.735030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/19/2021] [Indexed: 12/31/2022] Open
Abstract
Asthma is a complex and heterogenous disease characterized by variability in disease expression and severity. Multiple extrapulmonary comorbidities and treatable traits are common in people with asthma, and there is an increasing appreciation of how these may complicate asthma management. This review will discuss the prevalence and impact of extrapulmonary comorbidities/risk factors or "traits," which have been found to co-exist in asthma (obesity, symptoms of depression and/or anxiety and physical inactivity), the impact these traits have on future outcomes (including exacerbation risk and quality of life) and asthma management, and how we should target treatment in asthma when these extrapulmonary traits are present.
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Affiliation(s)
- Rebecca F McLoughlin
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
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2
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[Diet and asthma: Better eating for better breathing?]. Rev Mal Respir 2021; 38:278-288. [PMID: 33676796 DOI: 10.1016/j.rmr.2021.02.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
Inhaled therapies are the cornerstone of asthma treatment. However, according to national and international guidelines, non-pharmacological interventions should not be neglected in asthma. It has been demonstrated that a healthy diet is beneficial to general health. Recently, the effect of diet on asthma has been highlighted in many studies. Two diets have been particularly studied: the Mediterranean diet (high in fruits and vegetables and low in fat) and the Western diet (high in saturated fat and low in fruits and vegetables). A beneficial effect of the Mediterranean diet and deleterious effect of the Western diet on the development or control of asthma has been shown in some studies even after adjustment for overweight. Study findings have not been unanimous, probably related to the complexity of conducting studies on a diet that may change from day to day for any individual subject. In addition, the effect of physical exercise, which is known to be beneficial in asthma, is rarely taken into account in these studies. However, studies on diet are becoming more complex with the use of specific dietary indices, which should bring interesting data in the future.
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Musharrafieh U, Tamim H, Houry R, AlBuhairan F. A nationwide study of asthma correlates among adolescents in Saudi Arabia. Asthma Res Pract 2020; 6:3. [PMID: 32514367 PMCID: PMC7262750 DOI: 10.1186/s40733-020-00056-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 04/27/2020] [Indexed: 11/15/2022] Open
Abstract
Background Asthma is a chronic airway inflammation disease that is frequently found in children and adolescents with an increasing prevalence. Several studies are linking its presence to many lifestyle and health correlates. The objective of this study was to explore these correlates and find characteristics of self-reported asthmatics among adolescents in Saudi Arabia. Methods This is a cross-sectional, school-based study carried out in all 13 regions of Saudi Arabia. Sampling was randomly done from intermediate and secondary school students. Data in our study consisted of demographic characteristics, health conditions and lifestyle patterns and were compared between the two groups: asthmatics versus non-asthmatics. Comparison between the two groups was done by analyzing our data using Statistical Analysis Software SURVEYFREQ procedure (SAS Version 9; SAS Institute, Cary, NC). Results Among a sample of 11,348 participants, the prevalence of self-reported asthma was found to be 8.2%. Various characteristics were found significantly different between the 2 groups including the gender, the weight, the family’s education, and dietary patterns. Self –reported asthmatic were more likely to be males, overweight or obese, with a lower father’s level of education and a higher consumption of milk and power drinks. Conclusion Asthma disease remains prevalent among adolescents in Saudi Arabia and requires higher awareness and better guidance for its prevention and treatment. Further efforts should focus on health promotion and lifestyle wellness to support preventive efforts of this chronic disease condition.
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Affiliation(s)
- Umayya Musharrafieh
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana Houry
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadia AlBuhairan
- Department of Pediatrics and Adolescent Medicine, AlDara Hospital and Medical Center; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Villeneuve T, Guilleminault L. [Asthma and obesity in adults]. Rev Mal Respir 2019; 37:60-74. [PMID: 31866123 DOI: 10.1016/j.rmr.2019.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/06/2019] [Indexed: 12/31/2022]
Abstract
Asthma is a chronic inflammatory airway disorder characterized by a multitude of phenotypes. Epidemiological studies show an increase in asthma prevalence in obese patients regardless of age. The association of asthma and obesity is now considered as a phenotype with its own clinical, biological and functional characteristics. Regarding the pathophysiology of asthma and obesity, numerous factors such as nutrition, genetic predisposition, microbiome, ventilatory mechanics and the role of adipose tissue have been identified to explain the heterogeneous characteristics of patients with asthma and obesity. In adult patients with asthma and obesity, respiratory symptoms are particularly prominent and atopy and eosinophilic inflammation is uncommon compared to normal weight asthma patients. Obese asthma patients experience more hospitalizations and use more rescue medications than normal weight asthmatics. Management of asthma in obese patients is complex because these patients have less response to the usual anti-asthmatic treatments. Weight loss through caloric restriction combined with exercise is the main intervention to obtain improvement of asthma outcomes. Bariatric surgery is an invasive procedure with interesting results.
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Affiliation(s)
- T Villeneuve
- Pôles des voies respiratoires, hôpital Larrey, CHU de Toulouse, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France
| | - L Guilleminault
- Pôles des voies respiratoires, hôpital Larrey, CHU de Toulouse, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France; Centre de physiopathologie de Toulouse Purpan (CPTP-U1043, Inserm, équipe 12), UPS, Toulouse, France.
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Abstract
In the Decade of Nutrition, food must be reconsidered. The main objective of our research was to establish if there are any correlations between ultraprocessed food consumption and increased asthma prevalence or other respiratory outcomes. Meanwhille, it will be an important step to design some lifestyle recommendations with direct benefits for asthma treatment. NOVA system for food classification is a new concept addressing food quality. Ultraprocessed food, made entirely from substances derived from food and additives, that includes other sources of nutrients and energy, is not usually used in culinary preparation. How asthma outcomes are influenced by Western diet that contains a lot of processed food and what benefits could arise from the Mediterranean diet are subjects for interesting studies. Substantial correlations have been established between unhealthy diets, especially Western diet, ultraprocessed foods and food allergies and asthma pathogenesis and control. NOVA clasification of processing foods and dietary inflammatory index are helpful tools in early identifying of correct dietary approach in asthma. More research in nutrition recommendations for asthma patients must be done and practical guidelines in nutritional interventions are future steps.
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Affiliation(s)
| | - Florin Mihaltan
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriela Radulian
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Nyenhuis SM, Shah N, Ma J, Marquez DX, Wilbur J, Cattamanchi A, Sharp LK. Identifying barriers to physical activity among African American women with asthma. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1582399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- S. M. Nyenhuis
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - N. Shah
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - J. Ma
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - D. X. Marquez
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - J. Wilbur
- Department of Women, Children, and Family Nursing, Rush University, Chicago, IL, USA
| | - A. Cattamanchi
- Department of Medicine, University of California, San Francisco, CA, USA
| | - L. K. Sharp
- Department of Pharmacy Systems, Outcomes and Pharmacoeconomics, University of Illinois at Chicago, Chicago, IL, USA
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Nyenhuis SM, Dixon AE, Ma J. Impact of Lifestyle Interventions Targeting Healthy Diet, Physical Activity, and Weight Loss on Asthma in Adults: What Is the Evidence? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:751-763. [PMID: 29221919 PMCID: PMC5948112 DOI: 10.1016/j.jaip.2017.10.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/10/2017] [Accepted: 10/26/2017] [Indexed: 02/07/2023]
Abstract
Unhealthy lifestyle factors such as poor diet quality, sedentary lifestyle, and obesity are associated with negative health consequences in asthma including poor asthma control, impaired quality of life, and greater health care utilization. Lifestyle modification is the cornerstone of behavioral treatments and has been effective in chronic diseases such as atherothrombotic vascular disease and diabetes. There is a critical need for lifestyle interventions in asthma care that address obesity and its intimately linked risk behaviors in terms of poor diet and physical inactivity. We present in this commentary the promising lifestyle interventions emerging in asthma care that target poor diet, physical inactivity and weight loss, the proposed mechanisms of these lifestyle interventions, and the critical need for guideline-concordant lifestyle interventions in asthma care.
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Affiliation(s)
- Sharmilee M Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Ill.
| | - Anne E Dixon
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Vermont, Burlington, Vt
| | - Jun Ma
- Department of Health Policy and Administration, Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Ill
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Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM. A Systematic Review of Associations of Physical Activity and Sedentary Time with Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1968-1981.e2. [PMID: 29510231 DOI: 10.1016/j.jaip.2018.02.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/05/2018] [Accepted: 02/22/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Physical inactivity and high sedentary time are associated with adverse health outcomes in several diseases. However, their impact in asthma is less clear. OBJECTIVE We aimed to synthesize the literature characterizing physical activity and sedentary time in adults with asthma, to estimate activity levels using meta-analysis, and to evaluate associations between physical activity and sedentary time and the clinical and physiological characteristics of asthma. METHODS Articles written in English and addressing the measurement of physical activity or sedentary time in adults ≥18 years old with asthma were identified using 4 electronic databases. Meta-analysis was used to estimate steps/day in applicable studies. RESULTS There were 42 studies that met the inclusion criteria. Physical activity in asthma was lower compared with controls. The pooled mean (95% confidence interval) steps/day for people with asthma was 8390 (7361, 9419). Physical activity tended to be lower in females compared with males, and in older people with asthma compared with their younger counterparts. Higher levels of physical activity were associated with better measures of lung function, disease control, health status, and health care use. Measures of sedentary time were scarce, and indicated a similar engagement in this behavior between participants with asthma and controls. High sedentary time was associated with higher health care use, and poorer lung function, asthma control, and exercise capacity. CONCLUSIONS People with asthma engage in lower levels of physical activity compared with controls. Higher levels of physical activity may positively impact on asthma clinical outcomes. Sedentary time should be more widely assessed.
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Affiliation(s)
- Laura Cordova-Rivera
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, Queensland, Australia; Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
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Magwene EM, Quiñones AR, Marshall GL, Makaroun LK, Thielke S. Older adults rate their mental health better than their general health. J Public Health Res 2017; 6:967. [PMID: 29071258 PMCID: PMC5641665 DOI: 10.4081/jphr.2017.967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/11/2017] [Indexed: 11/28/2022] Open
Abstract
Background. Self-rated health (SRH) shows strong associations with measures of health and well-being. Increasingly, studies have used self-rated mental health (SRMH) as a predictor of various outcomes, independently or together with SRH. Research has not firmly established if and how these two constructs differ. We sought to characterize the relationship between SRH and SRMH, and to determine how this relationship differed across subgroups defined by sociodemographic and health-related characteristics. Design and methods. We analyzed data from the 2012 CAHPS Medicare Advantage Survey. SRH and SRMH ratings were crosstabulated to determine the distribution of responses across response categories. The expected joint probability distribution was computed and compared to the observed distribution. A constructed variable indicated whether SRMH was better, the same, or worse than SRH. We analyzed the distribution of this variable across various subgroups defined by sociodemographic and health-related factors. Results. A total of 114,905 Medicare Advantage beneficiaries responded to both the SRH and SRMH questions. Both in general and within all subgroups, SRMH was usually rated as better than SRH, and rarely as worse. Conclusions. Within a large group of Medicare recipients, the overwhelming trend was for recipients to rate their mental health as at least as good as their overall health, regardless of any sociodemographic and health-related factors. This finding of a shifted distribution encourages caution in the analytic use of selfrated mental health, particularly the use of both SRH and SRMH for adjustment. Additional research is needed to help clarify the complex relationship between these variables. Significance for public health Self-rated health (SRH) has become established as a general measure of health status, but less is known about self-rated mental health (SRMH). Recent epidemiological studies have included self-rated mental health (SRMH) without scrutinizing its properties and in particular its relationship with SRH. In a large dataset of Medicare recipients, we found that self-rated mental health was consistently rated better than self-rated health, across all patient groups. None of the sociodemographic or health factors we examined accounted for this discrepancy. Self-rated mental health seemed to be more resistant to the effects of medical illnesses and functional impairments than was self-rated health. This points to a likely difference in how people formulate and differentiate between their mental and general health, with mental health being seen as more separate from other health factors. These findings encourage caution in the use of SRMH in analytic models, especially if included simultaneously with SRH.
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Affiliation(s)
- Elena M Magwene
- Mental Health Service, VA Puget Sound Health Care System, Seattle, WA
| | | | | | - Lena K Makaroun
- University of Washington, Seattle, WA.,VA Health Services Research and Development, VA Puget Sound Healthcare System, Seattle, WA
| | - Stephen Thielke
- University of Washington, Seattle, WA.,Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
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Good J, Jagroop D, Dogra S. Sociodemographic, health-related and lifestyle correlates of physical activity in adults with current asthma. J Asthma 2016; 54:69-76. [PMID: 27285062 DOI: 10.1080/02770903.2016.1194432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Regular physical activity is associated with better asthma control; however, little is known of the determinants of physical activity in a population of adults with asthma. Thus, the purpose of this study was to identify important sociodemographic, health and lifestyle correlates of physical activity among adults with asthma. METHODS Data from adults with asthma aged 18-44 years (n = 2740) from the Canadian Community Health Survey (CCHS), 2011-2012 annual component were used for analysis. The main outcome was Daily Energy Expenditure (DEE). This variable was based on frequency and duration of leisure activities in the past 3 months. Self-reported sociodemographic (age, sex, total household income, highest education level, and ethnicity), health-related (body mass index (BMI), self-perceived health, mood disorder, anxiety disorder, and asthma symptoms/attacks, past year) and lifestyle (type of smoker, sedentary time, fruit and vegetable consumption) variables were assessed as correlates for DEE. Data were analysed using linear regressions. RESULTS In the final model, sociodemographic correlates accounted for 4.2% of the variation in DEE. Adding health correlates increased the R2 to 12.1%. Finally, adding lifestyle correlates increased the R2 to 17.6%. CONCLUSIONS In adults with current asthma, the main correlates of physical activity are age, total household income, BMI, self-perceived health, anxiety disorder, sedentary time, and fruit and vegetable consumption. These data are important for informing education and exercise interventions for adults with asthma. Future research is needed to determine asthma-specific correlates of physical activity.
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Affiliation(s)
- Joshua Good
- a Faculty of Health Sciences, University of Ontario Institute of Technology , Oshawa , Ontario , Canada
| | - David Jagroop
- a Faculty of Health Sciences, University of Ontario Institute of Technology , Oshawa , Ontario , Canada
| | - Shilpa Dogra
- a Faculty of Health Sciences, University of Ontario Institute of Technology , Oshawa , Ontario , Canada
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Ahmad F, Jhajj AK, Stewart DE, Burghardt M, Bierman AS. Single item measures of self-rated mental health: a scoping review. BMC Health Serv Res 2014; 14:398. [PMID: 25231576 PMCID: PMC4177165 DOI: 10.1186/1472-6963-14-398] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 09/09/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A single-item measure of self-rated mental health (SRMH) is being used increasingly in health research and population health surveys. The item asks respondents to rate their mental health on a five-point scale from excellent to poor. This scoping study presents the first known review of the SRMH literature. METHODS Electronic databases of Medline, CINAHL, PsycINFO, EMBASE and Cochrane Reviews were searched using keywords. The databases were also searched using the titles of surveys known to include the SRMH single item. The search was supplemented by manually searching the bibliographic sections of the included studies. Two independent reviewers coded articles for inclusion or exclusion based on whether articles included SRMH. Each study was coded by theme and data were extracted about study design, sample, variables, and results. RESULTS Fifty-seven studies included SRMH. SRMH correlated moderately with the following mental health scales: Kessler Psychological Distress Scale, Patient Health Questionnaire, mental health subscales of the Short-Form Health Status Survey, Behaviour and Symptom Identification Scale, and World Mental Health Clinical Diagnostic Interview Schedule. However, responses to this item may differ across racial and ethnic groups. Poor SRMH was associated with poor self-rated health, physical health problems, increased health service utilization and less likelihood of being satisfied with mental health services. Poor or fair SRMH was also associated with social determinants of health, such as low socioeconomic position, weak social connections and neighbourhood stressors. Synthesis of this literature provides important information about the relationships SRMH has with other variables. CONCLUSIONS SRMH is associated with multi-item measures of mental health, self-rated health, health problems, service utilization, and service satisfaction. Given these relationships and its use in epidemiologic surveys, SRMH should continue to be assessed as a population health measure. More studies need to examine relationships between SRMH and clinical mental illnesses. Longitudinal analyses should look at whether SRMH is predictive of future mental health problems.
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Affiliation(s)
- Farah Ahmad
- />School of Health Policy and Management, Faculty of Health, York University, 4700 Keele Street, HNES 414, Ontario, M3J 1P3 Canada
| | - Anuroop K Jhajj
- />OPTIMUS | SBR, 30 Adelaide St. E, Suite 600, Toronto, ON M5C 3G8 Canada
| | - Donna E Stewart
- />Women’s Health Program at University Health Network, University of Toronto, 200 Elizabeth St, Toronto, M5G 2C4 Canada
| | - Madeline Burghardt
- />School of Heath Policy and Management, Critical Disability Studies, Faculty of Health, York University, 4700 Keele Street, Ontario, M3J 1P3 Canada
| | - Arlene S Bierman
- />Lawrence S. Bloomberg Faculty of Nursing; Institute of Health Policy, Management and Evaluation; Dalla Lana School of Public Health and Department of Medicine, Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, ON M5B 1 W8 Canada
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Avallone KM, McLeish AC. Asthma and aerobic exercise: a review of the empirical literature. J Asthma 2013; 50:109-16. [PMID: 23252987 DOI: 10.3109/02770903.2012.759963] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of the present article was to provide a comprehensive review of the empirical literature on the association between asthma and aerobic exercise among adults. METHODS A literature search was conducted utilizing electronic search engines (i.e., PsycINFO and PubMed) using the following keyword algorithms: asthma AND (exercise OR physical activity). RESULTS These searches resulted in approximately 5665 citations. Only results that were directly relevant were included in the present review. CONCLUSIONS Overall, empirical evidence suggests that (1) individuals with asthma are less likely to engage in physical activity than those without asthma, (2) individuals with asthma are not biased in their subjective reporting of symptoms during aerobic exercise, (3) physical inactivity among individuals with asthma is associated with negative health consequences and increased asthma-related difficulties, and (4) regular aerobic exercise improves asthma symptom management, lung function, and mental health.
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Affiliation(s)
- Kimberly M Avallone
- Department of Psychology, University of Cincinnati , Cincinnati, OH 45221-0376, USA
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Mancuso CA, Choi TN, Westermann H, Wenderoth S, Wells MT, Charlson ME. Improvement in asthma quality of life in patients enrolled in a prospective study to increase lifestyle physical activity. J Asthma 2012; 50:103-7. [PMID: 23173979 DOI: 10.3109/02770903.2012.743150] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Asthma patients know the benefits of exercise but often avoid physical activity because they are concerned that it will exacerbate asthma. The objective of this analysis was to assess longitudinal asthma status in 256 primary care patients in New York City enrolled in a trial to increase lifestyle physical activity. METHODS Patients were randomized to two protocols to increase physical activity during a period of 12 months. At enrollment, patients completed the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) and received asthma self-management instruction through an evaluative test and workbook. Exercise and self-management were reinforced every 2 months. The AQLQ was repeated every 4 months and the ACQ was repeated at 12 months. RESULTS The mean age was 43 years and 75% were women. At 12 months there were clinically important increases in physical activity with no differences between groups; thus, data were pooled for asthma analyses. The enrollment AQLQ score was 5.0 ± 1.3 and increased to 5.9 ± 1.1 corresponding to a clinically important difference. Correlations between AQLQ and physical activity were approximately 0.35 (p < .0001) at each time point. In a mixed effects model, the variables associated with improvement in AQLQ scores over time were male sex, less severe asthma, not taking asthma maintenance medications, fewer depressive symptoms, and increased physical activity (all variables, p < .03). According to the ACQ, asthma was well controlled in 38% at enrollment and in 60% at 12 months (p < .0001). CONCLUSION With attention to self-management, increased physical activity did not compromise asthma control and was associated with improved asthma.
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15
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Ahmed S, Bartlett SJ, Ernst P, Paré G, Kanter M, Perreault R, Grad R, Taylor L, Tamblyn R. Effect of a web-based chronic disease management system on asthma control and health-related quality of life: study protocol for a randomized controlled trial. Trials 2011; 12:260. [PMID: 22168530 PMCID: PMC3268749 DOI: 10.1186/1745-6215-12-260] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 12/14/2011] [Indexed: 11/24/2022] Open
Abstract
Background Asthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals. Effective patient self-management is critical for improving health outcomes. However, key aspects of self-management such as self-monitoring of behaviours and symptoms, coupled with regular feedback from the health care team, are rarely addressed or integrated into ongoing care. Health information technology (HIT) provides unique opportunities to facilitate this by providing a means for two way communication and exchange of information between the patient and care team, and access to their health information, presented in personalized ways that can alert them when there is a need for action. The objective of this study is to evaluate the acceptability and efficacy of using a web-based self-management system, My Asthma Portal (MAP), linked to a case-management system on asthma control, and asthma health-related quality of life. Methods The trial is a parallel multi-centered 2-arm pilot randomized controlled trial. Participants are randomly assigned to one of two conditions: a) MAP and usual care; or b) usual care alone. Individuals will be included if they are between 18 and 70, have a confirmed asthma diagnosis, and their asthma is classified as not well controlled by their physician. Asthma control will be evaluated by calculating the amount of fast acting beta agonists recorded as dispensed in the provincial drug database, and asthma quality of life using the Mini Asthma Related Quality of Life Questionnaire. Power calculations indicated a needed total sample size of 80 subjects. Data are collected at baseline, 3, 6, and 9 months post randomization. Recruitment started in March 2010 and the inclusion of patients in the trial in June 2010. Discussion Self-management support from the care team is critical for improving chronic disease outcomes. Given the high volume of patients and time constraints during clinical visits, primary care physicians have limited time to teach and reinforce use of proven self-management strategies. HIT has the potential to provide clinicians and a large number of patients with tools to support health behaviour change. Trial Registration Current Controlled Trials ISRCTN34326236.
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Affiliation(s)
- Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, 3654 Prom. Sir William Osler, Montreal, QC, Canada.
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Arne M, Lundin F, Boman G, Janson C, Janson S, Emtner M. Factors associated with good self-rated health and quality of life in subjects with self-reported COPD. Int J Chron Obstruct Pulmon Dis 2011; 6:511-9. [PMID: 22069362 PMCID: PMC3206767 DOI: 10.2147/copd.s24230] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recent guidelines for chronic obstructive pulmonary disease (COPD) state that COPD is both preventable and treatable. To gain a more positive outlook on the disease it is interesting to investigate factors associated with good, self-rated health and quality of life in subjects with self-reported COPD in the population. METHODS In a cross-sectional study design, postal survey questionnaires were sent to a stratified, random population in Sweden in 2004 and 2008. The prevalence of subjects (40-84 years) who reported having COPD was 2.1% in 2004 and 2.7% in 2008. Data were analyzed for 1475 subjects. Regression models were used to analyze the associations between health measures (general health status, the General Health Questionnaire, the EuroQol five-dimension questionnaire) and influencing factors. RESULTS The most important factor associated with good, self-rated health and quality of life was level of physical activity. Odds ratios for general health varied from 2.4 to 7.7 depending on degree of physical activity, where subjects with the highest physical activity level reported the best health and also highest quality of life. Social support and absence of economic problems almost doubled the odds ratios for better health and quality of life. CONCLUSIONS In this population-based public health survey, better self-rated health status and quality of life in subjects with self-reported COPD was associated with higher levels of physical activity, social support, and absence of economic problems. The findings indicated that of possible factors that could be influenced, promoting physical activity and strengthening social support are important in maintaining or improving the health and quality of life in subjects with COPD. Severity of the disease as a possible confounding effect should be investigated in future population studies.
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Affiliation(s)
- Mats Arne
- Primary Care Research Unit, County Council of Värmland, Universitetsgatan 3, Karlstad, Sweden.
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Westermann H, Choi TN, Briggs WM, Charlson ME, Mancuso CA. Obesity and exercise habits of asthmatic patients. Ann Allergy Asthma Immunol 2008; 101:488-94. [PMID: 19055202 PMCID: PMC2597623 DOI: 10.1016/s1081-1206(10)60287-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND National guidelines recommend 20 to 30 minutes of exercise 3 to 5 days a week. However, achieving these goals may be challenging for asthmatic patients whose symptoms are exacerbated by exercise. OBJECTIVE To describe relationships among exercise habits, weight, and asthma severity and control in adults with asthma. METHODS Self-reported exercise habits were obtained from 258 stable patients by using the Paffenbarger Physical Activity and Exercise Index. Disease status was measured by using the Asthma Control Questionnaire and the Severity of Asthma Scale. Exercise habits were evaluated in multivariate analyses with age, sex, education, body mass index, and asthma control and severity as independent variables. RESULTS The mean patient age was 42 years; 75% were women, 62% were college graduates, and 40% were obese. Only 44% of patients did any exercise. In bivariate analysis, patients with well-controlled asthma were more likely to exercise; however, in multivariate analysis, asthma control and severity were not associated, but male sex (P = .01), having more education (P = .04), and not being obese (P < .001) were associated. Asthma control and severity also were not associated with type, duration, or frequency of exercise, but not being obese was associated in multivariate analyses. Only 22% of all patients (49% of those who exercised) met national guidelines for weekly exercise. Not being obese was the only variable associated with meeting guidelines in multivariate analysis (P = .02). CONCLUSIONS Compared with the general population, a lower proportion of asthmatic patients did any routine exercise and met national exercise guidelines. Physicians need to manage asthma and obesity to help asthmatic patients meet exercise goals.
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Affiliation(s)
| | | | | | | | - Carol A. Mancuso
- Weill Cornell Medical College, New York, New York
- Hospital for Special Surgery, New York, New York
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Dogra S, Meisner BA, Baker J. Psychosocial predictors of physical activity in older aged asthmatics. Age Ageing 2008; 37:449-54. [PMID: 18515293 DOI: 10.1093/ageing/afn114] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND there is little information available on physical activity (PA) patterns and the psychosocial determinants of PA in older adults with asthma. OBJECTIVE to quantify the prevalence of PA in older asthmatics and to explore the potential psychosocial determinants of PA in this population. STUDY DESIGN AND SETTING cross-sectional data available from the Canadian Community Health Survey (CCHS), cycle 2.1, were used. There was a total of 1,772 older asthmatics in the sample. RESULTS there were significant differences in the prevalence of PA between older asthmatic females compared to middle-aged asthmatic females (chi(2) = 23.65, P < 0.0001) and older asthmatics compared to older non-asthmatics (chi(2) = 38.1, P < 0.0001). Logistic regression revealed a significant association between PA and perceived health in older asthmatic males (OR = 5.39, CI = 1.36-21.33) and females (OR = 4.81, CI = 1.41-16.38). Being a member of a volunteer organisation was also significantly associated with PA in older asthmatic females (OR = 1.59, CI = 1.11-2.30). CONCLUSION older asthmatics were less active than their non-asthmatic peers. Perceived health was an important predictor of PA in both older asthmatic males and females. Exercise interventions in this population should make an effort to improve self-perceived health.
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Affiliation(s)
- Shilpa Dogra
- Lifespan Health and Performance Laboratory, York University, North York, ON, M3 J 1P3, Canada.
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