Lozier Matthew J, Zahran Hatice S, Bailey Cathy M
a Division of Environmental Hazards and Health Effects , Centers for Disease Control and Prevention , San Juan , Puerto Rico.
J Asthma. 2019 Jan;56(1):42-49. doi: 10.1080/02770903.2018.1426767. Epub 2018 Feb 9.
Asthma affects six million children in the United States. Most people can control their asthma symptoms with effective care, management, and appropriate medical treatment. Information on the relationship between asthma control and quality of life indicators and health care use among school-age children is limited.
Using the 2006-2010 combined Behavior Risk Factor Surveillance System Asthma Call-back Survey child data, we examined asthma control and asthma attack status among school-age (aged 5-17 years) children with asthma from 35 states and the District of Columbia. Multivariable logistic regression models were used to assess if having uncontrolled asthma and having ≥1 asthma attacks affect quality of life (activity limitation and missed school days) and healthcare use (emergency department [ED] visits and hospitalizations).
About one-third (36.5%) of the 8,484 respondents with current asthma had uncontrolled asthma and 56.8% reported ≥1 asthma attack in the past year. Having uncontrolled asthma and having ≥1 asthma attack were significantly associated with activity limitation (aPR = 1.43 and 1.74, respectively), missed school (1.45 and 1.68), ED visits (2.05 and 4.78), and hospitalizations (2.38 and 3.64). Long-term control (LTC) medication use was higher among respondents with uncontrolled asthma (61.3%) than respondents with well-controlled asthma (33.5%).
Having uncontrolled asthma is associated with reduced quality of life and increased health care use. However, only 61.3% of respondents with uncontrolled asthma use LTC medications. Increasing use of LTC medications among children with uncontrolled asthma could help improve quality of life and reduce health care use.
在美国,哮喘影响着600万儿童。大多数人可以通过有效的护理、管理和适当的药物治疗来控制哮喘症状。关于学龄儿童哮喘控制与生活质量指标及医疗保健使用之间关系的信息有限。
利用2006 - 2010年综合行为危险因素监测系统哮喘回访调查的儿童数据,我们调查了来自35个州和哥伦比亚特区的5至17岁哮喘学龄儿童的哮喘控制情况和哮喘发作状况。使用多变量逻辑回归模型来评估哮喘未得到控制以及有≥1次哮喘发作是否会影响生活质量(活动受限和缺课天数)和医疗保健使用(急诊就诊和住院)。
在8484名患有当前哮喘的受访者中,约三分之一(36.5%)的哮喘未得到控制,56.8%的受访者报告在过去一年中有≥1次哮喘发作。哮喘未得到控制以及有≥1次哮喘发作与活动受限(调整后患病率分别为1.43和1.74)、缺课(1.45和1.68)、急诊就诊(2.05和4.78)以及住院(2.38和3.64)显著相关。哮喘未得到控制的受访者(61.3%)使用长期控制(LTC)药物的比例高于哮喘得到良好控制的受访者(33.5%)。
哮喘未得到控制与生活质量下降和医疗保健使用增加有关。然而,哮喘未得到控制的受访者中只有61.3%使用LTC药物。增加哮喘未得到控制的儿童对LTC药物的使用可能有助于改善生活质量并减少医疗保健使用。