Asthma That Is Not Well-Controlled Is Associated with Increased Healthcare Utilization and Decreased Quality of Life
Asthma That Is Not Well-Controlled Is Associated with Increased Healthcare Utilization and Decreased Quality of Life
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DOI：
10.3109/02770903.2010.535879
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发表时间：
2011-03-01
影响因子：
1.9
通讯作者：
Schatz, Michael
中科院分区：
文献类型：
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作者：
Guilbert, Theresa W.;Garris, Cindy;Schatz, Michael
背景哮喘控制与其他哮喘结果的关系尚未完全记录。Objective.本研究旨在探讨哮喘控制与健康相关生活质量（HRQL）和随后的医疗资源利用之间的关系。方法.对497名成人和170名儿童哮喘患者进行了为期1年的在线前瞻性纵向调查。控制通过哮喘控制测试（TM）（TM）（ACT）和儿童ACT（TM）（TM）（C-ACT）（TM）（TM）（TM）（TM）评分来衡量，这些评分被二分为“控制良好”。（得分> 19）或“控制不佳”（得分<千分之一货币符号19），使用PedsQL（TM）（TM）3.0哮喘模块（儿童）和SF-12健康调查（成人）测量HRQL。采用多变量模型进行分析。结果与哮喘控制良好的患者相比，哮喘控制不佳的成人（平均降低3.4）和儿童（平均降低12.8）的HRQL评分显著降低。基线时哮喘控制不佳的成人哮喘患者在随后9个月内因哮喘就诊的风险增加3倍，因哮喘就诊急诊科（艾德）的风险增加10倍（比值比（OR）分别为3.3和11.3）。未得到良好控制的哮喘儿童随后哮喘相关医生和艾德就诊的风险增加近5倍（OR分别为4.8和4.9）。结论与ACT评分较高的患者相比，哮喘控制不佳的成人和儿童的生活质量明显较低，更可能需要因哮喘就诊或艾德就诊。因此，重要的是要不断评估哮喘控制和调整控制器治疗。
Background. Relationships of asthma control to other asthma outcomes have been incompletely documented. Objective. This study examined the relationship between asthma control and health-related quality of life (HRQL) and subsequent healthcare resource utilization. Methods. A 1-year online prospective longitudinal survey was conducted in 497 adults and 170 children with asthma treated in the past year. Control was measured by Asthma Control Test (TM)(TM) (ACT) and Childhood ACT (TM)(TM) (C-ACT)(TM)(TM) scores dichotomized into ""well-controlled"" (scores > 19) or ""not well-controlled"" (scores < a parts per thousand currency sign19), and HRQL was measured using the PedsQL (TM)(TM) 3.0 Asthma Module (children) and the SF-12 Health Survey (adults). Multivariate models were used for analysis. Results. HRQL scores were significantly lower for adults (mean decrease 3.4) and children (mean decrease 12.8) whose asthma was not well-controlled compared to patients with well-controlled asthma. Adults with asthma that was not well-controlled at baseline had a threefold greater risk of an asthma-related doctor visit and a 10-fold greater risk of an emergency department (ED) visit for asthma in the subsequent 9 months (odds ratio (OR) == 3.3 and OR == 11.3, respectively). Children with asthma that was not well-controlled had a nearly fivefold increased risk for subsequent asthma-related doctors' and ED visits (OR == 4.8 and OR == 4.9, respectively). Conclusion. Both adults and children with not well-controlled asthma had significantly lower quality of life and were more likely to require an office or ED visit for asthma compared to patients with higher ACT scores. Therefore, it is important to continually assess asthma control and adjust controller therapy accordingly.