Association between respiratory prescribing, air pollution and deprivation, in primary health care
Association between respiratory prescribing, air pollution and deprivation, in primary health care
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DOI：
10.1093/pubmed/fdt107
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发表时间：
2013-12-01
影响因子：
4.4
通讯作者：
Pless-Mulloli, Tanja
中科院分区：
文献类型：
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作者：
Sofianopoulou, Eleni;Rushton, Stephen P.;Pless-Mulloli, Tanja
我们调查了初级卫生保健中呼吸道处方、空气质量和剥夺之间的关系。以前的大多数研究都使用二级和三级医疗数据来量化空气污染对哮喘和慢性阻塞性肺疾病（COPD）加重的影响。然而，这些结果捕获了患有相对严重症状的患者。这是一项基于人群的生态研究。我们分析了呼吸系统药物（沙丁胺醇）处方每月63初级保健的做法，英国。首先，我们捕捉了处方的区域性季节性变化。然后，使用处方的区域差异作为补偿，我们建立了一个混合效应模型，以评估与空气质量和人口统计学变量相关的剩余差异。环境PM10增加10 g/m3，与沙丁胺醇处方增加1（95 CI：0.12）相关。收入和就业剥夺增加1 SD与沙丁胺醇处方率分别增加20.5（95 CI：8.833.4）和14.7（95 CI：4.326.2）相关，该研究提供的证据表明，初级保健中每月的呼吸道处方是一个有用的指标，空气污染加剧哮喘和COPD症状的程度。呼吸系统处方在贫困人群中更高。
We investigated the association between respiratory prescribing, air quality and deprivation in primary health care. Most previous studies have used data from secondary and tertiary care to quantify air pollution effects on exacerbations of asthma and chronic obstructive pulmonary disease (COPD). However, these outcomes capture patients who suffer from relatively severe symptoms.This is a population-based ecological study. We analysed respiratory medication (salbutamol) prescribed monthly by 63 primary care practices, UK. Firstly, we captured the area-wide seasonal variation in prescribing. Then, using the area-wide variation in prescribing as an offset, we built a mixed-effects model to assess the remaining variation in relation to air quality and demographic variables.An increase of 10 g/m(3) in ambient PM10 was associated with an increase of 1 (95 CI: 0.12) in salbutamol prescribing. An increase of 1 SD in income and employment deprivation was associated with an increase of 20.5 (95 CI: 8.833.4) and 14.7 (95 CI: 4.326.2) in salbutamol prescribing rate, respectively.The study provides evidence that monthly respiratory prescribing in primary care is a useful indicator of the extent to which air pollution exacerbates asthma and COPD symptoms. Respiratory prescribing was higher on deprived populations.