Cançado Jose Eduardo Delfini, Penha Marcio, Gupta Shaloo, Li Vicky W, Julian Guilherme Silva, Moreira Eloisa de Sá
a Santa Casa da Misericórdia de São Paulo , São Paulo , Brazil.
b Astrazeneca do Brasil , São Paulo , Brazil.
J Asthma. 2019 Mar;56(3):244-251. doi: 10.1080/02770903.2018.1445267. Epub 2018 Mar 29.
To determine the association of asthma on health-related quality of life (QoL), productivity, and use of healthcare resources among adults in Brazil.
Data were analyzed from the 2015 Brazil National Health and Wellness Survey, a cross-sectional survey with 12,000 adult respondents. Asthma and control groups were compared with respect to health-related QoL, asthma control, work productivity, and adherence. Generalized linear models were developed to compare asthma-related associations controlling for potential confounding factors.
Among respondents, 4.1% (n = 494) reported an asthma diagnosis; those without asthma symptoms were used as the control group (n = 11,487). Regarding asthma control, 51.2% of patients had uncontrolled asthma, 36.4% partially controlled asthma, and 12.3% were fully controlled. Short-acting β2 agonists were the most commonly used class of drugs (38.5%). Approximately 32.4% of asthma patients were considered fully adherent to their treatment. In multivariable analyses, asthma patients presented lower health-related QoL and had more frequent visits with medical healthcare providers (6.1 versus 4.2) emergency room visits (1.0 versus 0.5), and more hospitalizations (0.4 versus 0.2), than control respondents six months prior to the study (p < 0.05). Rates of absenteeism and presenteeism varied between 11.5% and 7.4% (p < 0.05) and 30.4% and 20.9% (p < 0.001) between asthma patients and controls, respectively.
Asthma had a negative association on health-related QoL, work productivity, and use of healthcare resources. Excessive use of short-acting β2 agonists and poor treatment adherence reflect poor asthma control and suggest the need to implement new strategies for asthma treatment in Brazil.
确定哮喘与巴西成年人健康相关生活质量（QoL）、生产力及医疗资源利用之间的关联。
对2015年巴西国民健康与生活状况调查的数据进行分析，该调查为横断面调查，有12000名成年受访者。比较哮喘组与对照组在健康相关生活质量、哮喘控制情况、工作生产力及依从性方面的差异。建立广义线性模型以比较控制潜在混杂因素后的哮喘相关关联。
在受访者中，4.1%（n = 494）报告有哮喘诊断；无哮喘症状者作为对照组（n = 11487）。关于哮喘控制情况，51.2%的患者哮喘未得到控制，36.4%部分得到控制，12.3%得到完全控制。短效β2激动剂是最常用的药物类别（38.5%）。约32.4%的哮喘患者被认为完全依从治疗。在多变量分析中，与研究前六个月的对照受访者相比，哮喘患者的健康相关生活质量较低，看医疗保健提供者的次数更频繁（6.1次对4.2次）、急诊就诊次数更多（1.0次对0.5次）、住院次数更多（0.4次对0.2次）（p < 0.05）。哮喘患者与对照组的缺勤率和出勤但低效工作率分别在11.5%至7.4%（p < 0.05）和30.4%至20.9%（p < 0.001）之间。
哮喘与健康相关生活质量、工作生产力及医疗资源利用呈负相关。短效β2激动剂的过度使用和治疗依从性差反映了哮喘控制不佳，表明巴西需要实施新的哮喘治疗策略。
