哮喘联盟

   摘要
   目的：评价健康认知力(HL)与老年人哮喘预后间的相关性。
   方法：本研究纳入了纽约和芝加哥的年龄≥60岁的中重度哮喘患者。采用哮喘控制问卷(ACQ)评估哮喘控制，呼吸量测定法预测1秒用力呼气量(FEV1)百分比，过去6个月里住院治疗以及急诊室(ED)的访问次数，以及生活质量评估。采用成人健康认知功能简短试验(S-TOFHLA)评估HL。多因素logistic回归分析模型控制年龄、性别、种族、收入、总体健康状况和哮喘患病年数。
   结果：433例患者中，36%为低HL，55%年龄超过65岁，38%为西班牙裔，22%为黑人。结果报告40%的患者哮喘控制不佳，32%FEV1 < 70%预计值；9%有过一次住院治疗，23%有过一次急诊室治疗，38%生活质量差。经多因素分析，低HL患者更可能发生FEV1 < 70%预计值(比值比 [OR] 2.34, 95% 置信区间[CI] 1.39-3.94, p=0.001)、因哮喘导致的住院治疗(OR 2.53, 95% CI 1.17-5.49, p=0.02)和急诊室治疗(OR 1.81, 95% CI 1.05-3.10, p=0.03)。患者自述的哮喘控制与生活质量无差异。
   结论：低HL与客观评估的哮喘控制不佳、更高的急诊室治疗和住院概率相关。HL是一个可改善老年人哮喘结果的可控干预目标。
 

（林江涛 审校）
J Asthma. 2013 Oct 8. [Epub ahead of print]


 

Asthma Outcomes Are Poor among Older Adults with Low Health Literacy.
 

Federman AD, Wolf MS, Sofianou A, O'Conor R, Martynenko M, Halm EA, Leventhal H, Wisnivesky JP.
 

Abstract
ABSTRACT OBJECTIVE: To examine the association of health literacy (HL) with asthma outcomes among older asthmatics.
METHODS: The study included adults ages ≥60 with moderate to severe asthma in New York City and Chicago. We assessed asthma control with the Asthma Control Questionnaire (ACQ) and the percent predicted forced expiratory volume at 1 second (FEV1) by spirometry, hospitalizations and emergency department (ED) visits in the past 6 months, and quality of life. HL was assessed with the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Multivariate logistic regression models controlled for age, sex, race, income, general health, and years with asthma.
RESULTS: Among 433 individuals, 36% had low HL, 55% were over age 65, 38% were Hispanic, and 22% were black. Poor asthma control was reported by 40% and 32% had FEV1 < 70% of predicted; 9% had a hospital stay, 23% had an ED, and 38% had poor quality of life. In multivariable analysis, individuals with low HL were more likely to have FEV1 < 70% predicted (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.39-3.94, p=0.001), hospitalizations (OR 2.53, 95% CI 1.17-5.49, p=0.02) and ED visits for asthma (OR 1.81, 95% CI 1.05-3.10, p=0.03). There were no differences in self-reported asthma control and quality of life.
CONCLUSIONS:Low HL is associated with poor asthma control by objective measure, and greater likelihood of ED visits and hospitalization. HL is a modifiable target for interventions to improve asthma outcomes in the elderly.
 

J Asthma. 2013 Oct 8. [Epub ahead of print]