Mental health, long-term medication adherence, and the control of asthma symptoms among persons exposed to the WTC 9/11 disaster.
Mental health, long-term medication adherence, and the control of asthma symptoms among persons exposed to the WTC 9/11 disaster.
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DOI：
10.1080/02770903.2019.1672722
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Cone J
中科院分区：
文献类型：
--
作者：
Brite J;Friedman S;de la Hoz RE;Reibman J;Cone J
在世贸中心暴露人群中，心理健康状况与哮喘控制不良之间存在正相关。药物依从性等因素是否介导了这种关联尚不清楚。研究人群来自世界贸易中心健康登记队列的成年参与者，他们在灾难后自我报告为哮喘，目前正在接受长期控制药物（LTCM）。多变量线性回归用于评估心理健康状况（PTSD、抑郁或焦虑）与持续依从性和哮喘控制测试（ACT）评分之间的相关性。在1，293例研究样本中，49%的人没有遵守LTCM，三分之二的人报告哮喘控制不佳或非常差。任何心理健康状况的存在与ACT下降2分和依从性评分下降半分相关。然而，在多变量模型中，更好的依从性与略差的控制在统计学上显著相关。心理健康对哮喘控制的总体影响与心理健康与依从性以及依从性与哮喘控制之间路径的乘积符号相反;因此，我们没有发现任何证据支持依从性介导不良心理健康状况与哮喘之间的负相关性的假设。充分的哮喘控制。需要更多的研究来了解心理和呼吸健康之间联系的复杂因果机制。
A positive association between mental health conditions and poor asthma control has been documented in the World Trade Center-exposed population. Whether factors such as medication adherence mediate this association is unknown. The study population was drawn from adult participants of the World Trade Center Health Registry Cohort who self-reported as asthmatic after the disaster and who were currently prescribed a long-term control medication (LTCM). Multivariable linear regression was used to estimate the associations between mental health condition (PTSD, depression, or anxiety) and continuous adherence and Asthma Control Test (ACT) scores. In the study sample of 1,293, 49% were not adherent to their LTCM and two thirds reported poorly or very poorly controlled asthma. Presence of any mental health condition was associated with a 2-point decline in ACT and half a point decrease in adherence scores. However, in the multivariable model, better adherence was statistically significantly associated with slightly worse control. The total effect of mental health on asthma control was opposite in sign from the product of the paths between mental health and adherence and adherence and asthma control; we therefore found no evidence to support the hypothesis that adherence mediated the negative association between poor mental health and adequate asthma control. More research is needed to understand the complex causal mechanisms that underlie the association between mental and respiratory health.
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影响因子：
10
作者：
Kandane-Rathnayake, R. K.;Matheson, M. C.;Walters, E. H.
通讯作者：
Walters, E. H.
DOI：
10.1164/rccm.201605-1067oc
发表时间：
2016-12-01
影响因子：
24.7
作者：
de la Hoz, Rafael E.;Jeon, Yunho;Celedon, Juan C.
通讯作者：
Celedon, Juan C.
影响因子：
4.5
作者：
Ghuman SJ;Brackbill RM;Stellman SD;Farfel MR;Cone JE
通讯作者：
Cone JE
影响因子：
2.7
作者：
Adams, RE;Boscarino, JA;Galea, S
通讯作者：
Galea, S
DOI：
10.1007/s11524-008-9317-4
发表时间：
2008-11-01
影响因子：
6.6
作者：
Farfel, Mark;DiGrande, Laura;Thorpe, Lorna
通讯作者：
Thorpe, Lorna