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加利福尼亚州成年哮喘患者中的暴饮、心理健康不佳与治疗依从性

Binge drinking, poor mental health, and adherence to treatment among California adults with asthma.

作者信息

Haskard Kelly B, Banta Jim E, Williams Summer L, Haviland Mark G, DiMatteo M Robin, Przekop Peter, Werner Leonard S, Anderson Donald L

机构信息

Texas State University, San Marcos, Texas, USA.

出版信息

J Asthma. 2008 Jun;45(5):369-76. doi: 10.1080/02770900801971776.

Abstract

Binge drinking and poor mental health may affect adherence to treatment for individuals with asthma. The purposes were to (a) examine the relationship of self-reported binge drinking and mental health to adherence to daily asthma control medications and (b) identify other demographic and health-related factors associated with asthma control medication adherence. Secondary analyses of 2003 adult California Health Interview Survey data were undertaken, and these analyses identified 3.2 million California adults who had been told by a physician they had asthma. Of these, approximately 1.7 million were symptomatic. Binge drinking significantly predicted medication nonadherence among California adults with symptomatic asthma (OR = .63, 95% CI = .45-.89), whereas poor mental health did not. Other predictors of nonadherence (odds ratios < 1, p < .05) included being overweight, younger age, having some college education, being a current smoker, and having no usual source of medical care. Predictors of adherence (odds ratios > 1, p < .05) were older age, more frequent asthma symptoms, more ER visits, more missed work days, being African American, and being a non-citizen. Intervention efforts could be directed toward improving medication adherence among adult asthma patients who engage in risky health behaviors such as binge drinking. Also at risk for medication nonadherence and therefore good targets for asthma control medication management interventions are adults who are overweight, younger (18-44 age range), have some college education, and no usual source of medical care.

摘要

酗酒和心理健康不佳可能会影响哮喘患者的治疗依从性。本研究的目的是:(a)研究自我报告的酗酒和心理健康与每日哮喘控制药物治疗依从性之间的关系;(b)确定与哮喘控制药物治疗依从性相关的其他人口统计学和健康相关因素。对2003年加利福尼亚健康访谈调查数据进行了二次分析,这些分析确定了320万被医生告知患有哮喘的加利福尼亚成年人。其中,约170万人有症状。酗酒显著预测了有症状的加利福尼亚成年哮喘患者的药物治疗不依从性(OR = 0.63,95%CI = 0.45 - 0.89),而心理健康不佳则没有。其他不依从性的预测因素(比值比<1,p<0.05)包括超重、年龄较小、接受过一些大学教育、目前吸烟以及没有固定的医疗保健来源。依从性的预测因素(比值比>1,p<0.05)包括年龄较大、哮喘症状更频繁、急诊就诊次数更多、误工天数更多、非裔美国人以及非公民。干预措施可以针对改善那些有酗酒等危险健康行为的成年哮喘患者的药物治疗依从性。超重、年龄较小(18 - 44岁)、接受过一些大学教育且没有固定医疗保健来源的成年人也有药物治疗不依从的风险,因此是哮喘控制药物管理干预的良好目标人群。

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