Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
BMC Pulm Med. 2023 Jan 24;23(1):34. doi: 10.1186/s12890-022-02259-6.
During the transition from paediatric to adult healthcare there is a gap between asthma guidelines and actual management with decreased healthcare consultations and dispensations of asthma medications after the transition to adult healthcare among young people with asthma. How health-related quality of life (HRQoL) develops during the transition from adolescence to young adulthood is unclear. Our aim was therefore to investigate HRQoL among young people with asthma during the transition to adulthood. Further, to assess if level of asthma control and physical activity influence any potential association between asthma and HRQoL.
The study population consisted of 2268 participants from the ongoing Swedish population-based prospective birth cohort BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology). HRQoL was measured using the instrument EQ-5D-3 L and three general questions. The EQ-5D-3 L consists of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The EQ-5D-3 L instrument and questions on general health, symptoms and treatment of asthma, and lifestyle factors were based on data from follow-ups at 16 and 24 years. Cross-sectional analyses were made.
At the 24-year follow-up, the adjusted median values of EQ VAS were lower compared with at the 16-year follow-up; among both participants with asthma (80 vs. 85, p < 0.01) and those without asthma (80 vs. 87, p < 0.01). At the 24-year follow-up, participants with uncontrolled asthma had a lower adjusted median EQ VAS score than peers with controlled/partly controlled asthma (75 vs. 80, p = 0.03). Further, young adults with asthma who did not fulfil the WHO recommendations on physical activity had lower EQ VAS scores than peers who did (70 vs. 80, p < 0.01).
HRQoL is lower in young adulthood than in adolescence. Young adults with asthma having uncontrolled disease or who are physically inactive appear to be particularly vulnerable.
在儿科向成人医疗保健过渡期间，哮喘指南与实际管理之间存在差距，青少年哮喘患者在过渡到成人医疗保健后，医疗保健咨询和哮喘药物的配给减少。从青春期到成年早期，健康相关生活质量（HRQoL）如何发展尚不清楚。因此，我们的目的是研究青少年哮喘患者在向成年过渡期间的 HRQoL。此外，评估哮喘控制水平和体力活动是否会影响哮喘与 HRQoL 之间的任何潜在关联。
该研究人群由正在进行的瑞典基于人群的前瞻性出生队列 BAMSE（Barn/Child，Allergy，Milieu，Stockholm，Epidemiology）中的 2268 名参与者组成。使用 EQ-5D-3L 仪器和三个一般问题来衡量 HRQoL。EQ-5D-3L 由 EQ-5D 描述系统和 EQ 视觉模拟量表（EQ VAS）组成。EQ-5D-3L 仪器以及关于一般健康、哮喘症状和治疗以及生活方式因素的问题基于 16 岁和 24 岁随访的数据。进行了横断面分析。
在 24 岁随访时，与 16 岁随访相比，调整后的 EQ VAS 中位数较低；在哮喘患者（80 对 85，p < 0.01）和非哮喘患者（80 对 87，p < 0.01）中均如此。在 24 岁随访时，未控制哮喘的参与者调整后的中位 EQ VAS 评分低于控制/部分控制哮喘的同龄人（75 对 80，p = 0.03）。此外，未达到世界卫生组织体力活动建议的哮喘青年成年人的 EQ VAS 评分低于达到该建议的同龄人（70 对 80，p < 0.01）。
HRQoL 在成年早期低于青春期。患有未控制疾病或体力活动不足的哮喘青年成年人似乎特别脆弱。
