Tasneem Zaihra1, Pierre Ernst2, Robyn Tamblyn3, Sara Ahmed4. 1. Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre de recherche interdisciplinaire en réadaptation (CRIR), Montreal, Quebec, Canada; Department of Mathematics, Brockport College, State University of New York, Brockport, New York. 2. Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 3. Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. 4. Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre de recherche interdisciplinaire en réadaptation (CRIR), Montreal, Quebec, Canada. Electronic address: sara.ahmed@mcgill.ca.
Abstract
BACKGROUND: Determining the factors that will predict long-term asthma control is essential for improving health outcomes and decreasing the burden on the health care system. Patient-reported outcomes (PROs) on health behaviors can provide valuable information about future asthma control but have rarely been considered in previous analyses. OBJECTIVE: To develop statistical models for evaluating the predictors of long-term asthma control using PROs such as scores of the Asthma Control Test and the Asthma Self-Efficacy Scale. METHODS: Of 1,437 individuals contacted, 566 (39%) at baseline and 486 (34%) at follow-up completed the questionnaires, including 4 PROs (Asthma Control Test, Asthma Self-Efficacy Scale, Mini-Asthma Quality of Life Questionnaire, and Beliefs about Medication Questionnaire). Long-term asthma control was evaluated by assessing overuse of rescue medication and emergency department visits. A multivariate logistic generalized estimating equation model was fitted to evaluate the possible effect of the studied factors on asthma control. RESULTS: The complete case generalized estimating equation analysis included 286 participants who had complete PROs at the 2 evaluation times. After adjusting for socioeconomic status and smoking status, the Mini-Asthma Quality of Life Questionnaire was a significant predictor of asthma exacerbation. For each 1-point increase on the Mini-Asthma Quality of Life Questionnaire, there was a 0.25 decrease in the odds of a patient's asthma getting out of control. CONCLUSION: These findings suggest opportunities to decrease the burden on health care by tailoring interventions that combine PROs with other clinical and sociodemographic variables.
BACKGROUND: Determining the factors that will predict long-term asthma control is essential for improving health outcomes and decreasing the burden on the health care system. Patient-reported outcomes (PROs) on health behaviors can provide valuable information about future asthma control but have rarely been considered in previous analyses. OBJECTIVE: To develop statistical models for evaluating the predictors of long-term asthma control using PROs such as scores of the Asthma Control Test and the Asthma Self-Efficacy Scale. METHODS: Of 1,437 individuals contacted, 566 (39%) at baseline and 486 (34%) at follow-up completed the questionnaires, including 4 PROs (Asthma Control Test, Asthma Self-Efficacy Scale, Mini-Asthma Quality of Life Questionnaire, and Beliefs about Medication Questionnaire). Long-term asthma control was evaluated by assessing overuse of rescue medication and emergency department visits. A multivariate logistic generalized estimating equation model was fitted to evaluate the possible effect of the studied factors on asthma control. RESULTS: The complete case generalized estimating equation analysis included 286 participants who had complete PROs at the 2 evaluation times. After adjusting for socioeconomic status and smoking status, the Mini-Asthma Quality of Life Questionnaire was a significant predictor of asthma exacerbation. For each 1-point increase on the Mini-Asthma Quality of Life Questionnaire, there was a 0.25 decrease in the odds of a patient's asthma getting out of control. CONCLUSION: These findings suggest opportunities to decrease the burden on health care by tailoring interventions that combine PROs with other clinical and sociodemographic variables.
Authors: Anna Bednarek; Anna Bodajko-Grochowska; Małgorzata Bartkowiak-Emeryk; Robert Klepacz; Janusz Ciółkowski; Danuta Zarzycka; Andrzej Emeryk Journal: Postepy Dermatol Alergol Date: 2018-06-18 Impact factor: 1.837