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Burruss CP, Pappal RB, Witt MA, Harryman C, Ali SZ, Bush ML, Fritz MA. Healthcare disparities for the development of airway stenosis from the medical intensive care unit. Laryngoscope Investig Otolaryngol 2022; 7:1078-1086. [PMID: 36000059 PMCID: PMC9392386 DOI: 10.1002/lio2.865] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives/hypothesis Study design Methods Results Conclusion Level of evidence
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Affiliation(s)
| | - Robin B. Pappal
- Department of Otolaryngology ‐ Head and Neck Surgery University of Kentucky Lexington Kentucky USA
| | - Michael A. Witt
- College of Medicine University of Kentucky Lexington Kentucky USA
| | | | - Syed Z. Ali
- Department of Anesthesiology University of Kentucky Lexington Kentucky USA
| | - Matthew L. Bush
- Department of Otolaryngology ‐ Head and Neck Surgery University of Kentucky Lexington Kentucky USA
| | - Mark A. Fritz
- Department of Otolaryngology ‐ Head and Neck Surgery University of Kentucky Lexington Kentucky USA
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Alanazi AMM, Alqahtani MM, Alquaimi MM, Alotaibi TF, Algarni SS, Ismaeil TT, Alanazi AA, Alasmari MM, Alhuthail EA, Alasmari AM, Gibson-Young L, Jayawardene WP. Substance Use and Misuse among Adults with Chronic Obstructive Pulmonary Disease in the United States, 2015-2019: Prevalence, Association, and Moderation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:408. [PMID: 35010669 PMCID: PMC8744618 DOI: 10.3390/ijerph19010408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/18/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the advancements in chronic obstructive pulmonary disease (COPD) treatment, complications related to COPD exacerbation remain challenging. One associated factor is substance use/misuse among adults with COPD. Fewer studies, however, examined the prevalence and association between COPD and substance use and misuse. In addition, limited knowledge existed about the moderation effects of serious psychological distress and gender among adults with COPD and substance use/misuse. We aimed, therefore, to measure such prevalence, association, and moderation from nationally representative samples in the United States. METHOD Data were drawn from the 2015-2019 National Survey on Drug Use and Health. Weighted logistic regressions were used to measure the associations of last-month tobacco (cigarettes, cigars, pipe, and smokeless tobacco products), other licit and illicit substance use (alcohol, marijuana, cocaine, crack, heroin, hallucinogens, and inhalants), and substance misuse (pain relievers, tranquilizers, stimulants, and sedatives) among adults with COPD. Serious psychological distress and gender were tested as moderators in the association between COPD and substance use/misuse. RESULTS The findings revealed that adults with COPD [Weighted N = 53,115,718) revealed greater odds of cigarettes [adjusted odds ratio (aOR) = 2.48 (95%CI = 1.80-3.42)) and smokeless tobacco (aOR = 3.65 (95%CI = 1.75-7.65)). However, they were less likely to use alcohol (aOR = 0.61 (95%CI = 0.45-0.84)). Adults with COPD who had serious psychological distress were more likely to use pipe tobacco and alcohol; however, they were less likely to use hallucinogens and inhalants. Finally, males compared to females with COPD were less likely to use smokeless tobacco. CONCLUSION Adults with COPD in the United States were more likely to use tobacco products and less likely to use alcohol. In addition, serious psychological distress and gender were moderators in associations between COPD and substance use but not in substance misuse. Future studies should longitudinally assess the factors that may contribute to the initiation and progression of substance use and misuse among adults with COPD.
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Affiliation(s)
- Abdullah M. M. Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.M.A.); (T.F.A.); (S.S.A.); (T.T.I.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia;
| | - Mohammed M. Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.M.A.); (T.F.A.); (S.S.A.); (T.T.I.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia;
| | - Maher M. Alquaimi
- Department of Respiratory Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Tareq F. Alotaibi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.M.A.); (T.F.A.); (S.S.A.); (T.T.I.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia;
| | - Saleh S. Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.M.A.); (T.F.A.); (S.S.A.); (T.T.I.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia;
| | - Taha T. Ismaeil
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; (M.M.A.); (T.F.A.); (S.S.A.); (T.T.I.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia;
| | - Ahmad A. Alanazi
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia;
- Respiratory Services, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia
| | - Moudi M. Alasmari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia;
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Eyas A. Alhuthail
- Basic Sciences Department, College of Sciences and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia;
- Department of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Ali M Alasmari
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK;
- College of Medical Rehabilitation Sciences, Taibah University, Medina 42353, Saudi Arabia
| | | | - Wasantha P. Jayawardene
- Institute for Research on Addictive Behavior, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA;
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Racial Disparities in Health Risk Indicators Reported by Alabamians Diagnosed with COPD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189662. [PMID: 34574587 PMCID: PMC8470414 DOI: 10.3390/ijerph18189662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/01/2021] [Accepted: 09/09/2021] [Indexed: 12/27/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a growing public health problem in the southern United States, particularly in Alabama. However, very little is known about specific health risk factors disproportionately impacting Alabamians with COPD. We conducted a latent class analysis of 2015–2019 Behavioral Risk Factor Surveillance System data from 4057 Alabamians with COPD (White = 2947, Black = 873, Other = 237). Eighteen risk indicators were examined across three health-related domains: (1) comorbidities, (2) limited healthcare access, and (3) substance use/abuse. Racial disparities between Black and white Alabamians with COPD were assessed using configural similarity analysis. Findings showed that almost one-third (31%) of Alabamians with COPD were in the high-risk class for eight comorbidities, and nearly one-half (48.88%) belonged to the high-risk class for limited healthcare access. Black Alabamians with COPD who did not have health insurance were much more likely to be at high risk for limited healthcare access (94.44%) when compared to their counterparts with insurance (5.56%), χ2(df = 2) = 1389.94, p < 0.0001. Furthermore, the proportion of high-risk, uninsured Black Alabamians with COPD (94.44%) substantially exceeded the percentage of high-risk, uninsured white Alabamians with COPD (59.70%). Most Alabamians with COPD (82.97%) were at low risk for substance use/abuse. Future research should explore new mechanisms for facilitating better healthcare access among high-risk Alabamians living with COPD and other prevalent comorbidities. Greater attention should be focused on Black Alabamians with COPD who cannot afford adequate health insurance.
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