University of Wisconsin-Madison, Madison, WI, USA.
Morehouse School of Medicine, Atlanta, GA, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221101202. doi: 10.1177/21501319221101202.
To describe access to and use of prescription asthma medications, and to assess factors associated with asthma exacerbation, healthcare utilization, and health status among asthma patients treated at Federally Qualified Health Centers.
This is a retrospective cross-sectional study. We analyzed data from the 2014 National Health Center Patient Survey. This data is publicly available from the Health Resources and Services Administration. Data was collected from patients receiving face-to-face care from health centers funded under Section 330 of the Public Health Service Act. Data from patients was collected between October 8, 2014, and April 17, 2015. We included adult participants who reported having a diagnosis of asthma and confirmed that they still have asthma. Association between explanatory variables (access to prescription medications and use of asthma controller medications) and outcome variables (asthma exacerbations, asthma hospitalizations or emergency department visits, and self-rated health) was assessed using multivariable regression analyses while adjusting for demographics.
A total of 919 participants with asthma were included. Approximately 32% of the participants experienced delays in getting prescription medications, 26% were unable to get them, 60% experienced an asthma exacerbation last year, 48% rated their health as fair/poor, and 19% visited a hospital or an emergency department last year. Multivariable results showed that participants who were currently taking controller medications were more likely to have experienced an asthma exacerbation (OR = 4.02; 95% CI 1.91 to 8.45; < .01), or visited a hospital or an emergency department (OR = 3.07; 95% CI 1.39 to 6.73; < .01) in the last year compared with those who had never taken controller medications. Experiencing difficulties in accessing asthma medications was associated with lower self-rated health ( = -.51; 95% CI -0.94 to -0.08; = .02).
Future interventions should seek to improve asthma patient care and health outcomes using innovative strategies that act at multiple levels of the healthcare system (eg, individual, interpersonal, community levels).
描述处方哮喘药物的可及性和使用情况，并评估在接受联邦合格健康中心治疗的哮喘患者中，与哮喘恶化、医疗保健利用和健康状况相关的因素。
这是一项回顾性的横断面研究。我们分析了 2014 年国家医疗中心患者调查的数据。这些数据由公共卫生服务法案第 330 节资助的医疗中心的面对面护理患者提供，可从健康资源和服务管理局获得。数据于 2014 年 10 月 8 日至 2015 年 4 月 17 日期间收集。我们纳入了报告有哮喘诊断并确认仍患有哮喘的成年参与者。使用多变量回归分析评估解释变量（获得处方药物和使用哮喘控制药物）与结果变量（哮喘恶化、哮喘住院或急诊就诊和自我报告的健康状况）之间的关联，同时调整人口统计学因素。
共纳入 919 名哮喘患者。约 32%的参与者在获得处方药物时出现延迟，26%无法获得药物，60%的参与者去年经历了哮喘恶化，48%的参与者自我报告健康状况为一般/较差，19%的参与者去年去过医院或急诊室。多变量结果显示，目前正在服用控制药物的参与者更有可能在过去一年中经历哮喘恶化（比值比[OR] = 4.02；95%置信区间 [CI] 1.91 至 8.45； < .01）或去过医院或急诊室（OR = 3.07；95% CI 1.39 至 6.73； < .01）。在获得哮喘药物方面遇到困难与自我报告的健康状况较差相关（ = −0.51；95% CI−0.94 至−0.08； = .02）。
未来的干预措施应寻求使用创新策略来改善哮喘患者的护理和健康结果，这些策略可在医疗保健系统的多个层面（例如，个人、人际和社区层面）发挥作用。
