哮喘联盟

   摘要
   目前我们对心理压抑（PD）与哮喘未控制（UA）在造成生产力下降方面存在的潜在协同效应认识较少。本研究评估了心理困扰和哮喘未控制这两种可控因素对在职成年哮喘患者生产力下降所造成的影响。在2010.12－2012.8期间，我们在不列颠哥伦比亚省及加拿大地区随机地招募了300例成年哮喘患者。我们采用验证过的方法检测由于误工和出勤所带来的心理压抑以及生产力下降，采用2010年制定的全球哮喘防治策略评估受试者的哮喘控制情况。我们采用两部分回归模型分析哮喘未控制以及心理压抑对生产力下降的影响。与对照组相比（哮喘控制并且心理健康），哮喘未控制但心理健康的受试者每周生产力下降量为286加币（95%可信区间为$276－297），而哮喘控制但心理压抑的受试者每周生产力下降量为465加币（95%可信区间为$445-485），而哮喘未控制且心理压抑的受试者每周生产力下降量为449加币（95%可信区间为$437-462）。心理压抑与哮喘控制水平在导致生产力下降方面的协同效应不显著（p=0.22）。对于心理健康的受试者，哮喘未控制群体生产力下降的程度比哮喘控制者更明显；但是对于心理压抑的受试者，两者之间并无显著差异。对此的解释为：心理压抑对于生产力下降所造成的影响过大，从而导致哮喘控制的协同效应相对较弱。我们应该进一步评估改善哮喘患者群体心理压抑这一干预措施的影响。
 

（杨冬 审校）
Eur Respir J. 2015 Feb 5. pii: ERJ-01416-2014. [Epub ahead of print]


 

Interaction effect of psychological distress and asthma control on productivity loss?
 

Moullec G1, FitzGerald JM2, Rousseau R2, Chen W3, Sadatsafavi M4.
 

ABSTRACT
Little is known about the potential synergistic effect of comorbid psychological distress (PD) and uncontrolled asthma (UA) on productivity loss. We estimated the productivity loss associated with the combination of these two potentially preventable conditions in employed adults with asthma. A population-based random sample of 300 adults with asthma in British Columbia, Canada, was prospectively recruited between Dec 2010 and Aug 2012. PD and productivity loss due to absenteeism and presenteeism was measured using validated instruments, and asthma control was ascertained using 2010 Global Initiative for Asthma management strategy. We used two-part regression models to study the contribution of UA and PD to productivity loss. Compared with reference group (controlled asthma (CA)+noPD), those with UA+noPD had CAD$286 (95%CI $276-297) weekly productivity loss, and those with CA+PD had CAD$465 ($445-485). Those with UA+PD had CAD$449 (437-462) in productivity loss. There was no significant interaction effect of PD with asthma control levels on productivity loss (p=0.22). In patients without PD, uncontrolled asthma was associated with a higher productivity loss than controlled asthma, but this was not the case in patients with PD. This finding can be explained by the fact that the contribution of PD to productivity loss is so large that there is no room for synergy with asthma control. Future studies should assess the impact of interventions that modify PD in patients with asthma.
 

Eur Respir J. 2015 Feb 5. pii: ERJ-01416-2014. [Epub ahead of print]