中老年人群哮喘与健康相关生命质量

Asthma and health related quality of life in late midlife adults.

机构信息

School of Pharmacy, Southern Illinois University-Edwardsville, Edwardsville, United States.

出版信息

Res Social Adm Pharm. 2019 Jan;15(1):61-69. doi: 10.1016/j.sapharm.2018.03.003. Epub 2018 Mar 9.

DOI:10.1016/j.sapharm.2018.03.003

PMID:29555405

Abstract

BACKGROUND

Health related quality of life (HRQoL) reflects the impact of a chronic disease, such as asthma, from a patient perspective. Late midlife adults (50-64 years) have been identified by the Centers for Disease Control & Prevention as an important population for healthy aging.

OBJECTIVES

To evaluate the factors associated with HRQoL among late midlife adults with asthma.

METHODS

This study utilized data from 2012 to 2013 Behavioral Risk Factor Surveillance System Asthma Call Back Survey. Adults with current asthma and 50-64 years of age were included in the study. Independent variables were identified using the Andersen Behavioral Model of Health Services Utilization. HRQoL was defined using 4 domains including self-rated health, physical health, mental health and activity limitation. Descriptive statistics were used to assess sample characteristics. Bivariate and multivariate logistic regression models were used to examine factors associated with the four HRQoL domains. All analyses were stratified by asthma control status. Appropriate survey weights were used to account for the complex survey design.

RESULTS

The final sample consisted of 5857 (Weighted: 4 million) late midlife asthmatics, mostly female (66%) and White (72%). About 42% had fair/poor self-rated health, 33% had impaired physical health, 23% had impaired mental health, and 24% experienced activity limitation. Multivariate analyses found that Non-Hispanic African American adults were significantly more likely to report fair/poor self-rated health compared to Whites (Well-controlled asthma OR: 2.2, 95% CI: 1.2-4.1). Adults who experienced any cost barrier were significantly more likely to have activity limitations (Poorly controlled asthma OR: 1.6, 95% CI: 1.1-2.3). Adults with a respiratory comorbidity were more likely to report impaired physical health compared to adults without (Well controlled asthma OR: 1.7, 95% CI: 1.01-2.7).

CONCLUSION

Reducing respiratory comorbidities and cost barriers may improve HRQoL in asthmatic late midlife adults.

摘要

背景

健康相关生活质量（HRQoL）反映了慢性疾病（如哮喘）对患者的影响。疾病控制与预防中心将 50-64 岁的中年人确定为健康老龄化的重要人群。

目的

评估哮喘中年后期成年人与 HRQoL 相关的因素。

方法

本研究利用了 2012 年至 2013 年行为风险因素监测系统哮喘回拨调查的数据。研究纳入了当前患有哮喘且年龄在 50-64 岁的成年人。使用安德森健康服务利用行为模型确定了自变量。使用 4 个领域的自评健康、身体健康、心理健康和活动受限来定义 HRQoL。使用描述性统计来评估样本特征。使用双变量和多变量逻辑回归模型来检查与四个 HRQoL 领域相关的因素。所有分析均按哮喘控制状况进行分层。适当的调查权重用于考虑复杂的调查设计。

结果

最终样本包括 5857 名（加权：400 万）中年后期哮喘患者，其中大多数为女性（66%）和白人（72%）。约 42%的人自评健康状况不佳/较差，33%的人身体健康受损，23%的人心理健康受损，24%的人活动受限。多变量分析发现，非西班牙裔非裔美国人报告自评健康状况不佳/较差的可能性明显高于白人（控制良好的哮喘 OR：2.2，95%CI：1.2-4.1）。经历任何费用障碍的成年人更有可能出现活动受限（控制不佳的哮喘 OR：1.6，95%CI：1.1-2.3）。与没有呼吸道合并症的成年人相比，患有呼吸道合并症的成年人更有可能报告身体健康受损（控制良好的哮喘 OR：1.7，95%CI：1.01-2.7）。