Social complexity negatively influences lung function in cystic fibrosis after transfer to adult care.

BACKGROUND

Several nongenetic factors, such as socioeconomic status, environmental exposures, and adherence have been described to have an impact on outcomes in cystic fibrosis (CF).

OBJECTIVE

To determine the effect of social complexity on the % predicted forced expiratory volume (ppFEV ) before and after transfer to adult care among adolescents with CF.

METHODS

Retrospective, single center, cohort study included all patients with CF who were transitioned into adult care between 2005 and 2015 at Indiana University. Social complexity (Bob's level of social support, [BLSS]) was collected at transfer. Linear mixed regression models assessed the relationship between ppFEV decline over time and BLSS with other covariates.

RESULTS

The median age of the patients (N = 133) at the time of transfer was 20 years (interquartile range: 19-23). Overall, there was a decline in lung function over time in our population (ppFEV at 24 months pretransfer 77 ± 20%, ppFEV at 24 months, posttransfer 66 ± 24%; P < .001). The relationship between BLSS and ppFEV became more negative over time, even after adjusting for other covariates.

CONCLUSION

Social complexity is strongly associated with lung function decline after transfer to adult care.