RESUMO
INTRODUCTION: The health and financial burden of mild-persistent asthma has been poorly investigated. OBJECTIVE: Our aim was to compare the rate of hospital admissions that have occurred during the preceding year between children and adolescents with current mild-persistent (MP) and moderate-severe (MS) asthma. METHODS: We screened children and adolescents with asthma at eight outpatient clinics. The inclusion criteria were asthma diagnosis, age from 6 to 18 years and follow-up with a physician during the preceding 6 months. Subjects answered standardized questionnaires and underwent spirometry. RESULTS: We enrolled 220 MP and 102 MS asthmatic subjects. The proportion of subjects with HA during the preceding year was similar between MP and MS asthma groups (7% vs. 7%; p = .89). Symptoms score and the financial values spent by the family in the care of asthma were lower in MP asthma as compared with MS asthma group (asthma control questionnaire score 0.7 [0.3-1.0) vs. 2.0 [1.1-2.5]; p < .01) (asthma expenses in USD 13 [2-43] vs. 28 [10-83]; p < .01). The frequency of subjects using inhaled corticosteroids maintenance therapy was lower in the MP asthma group as compared with the MS asthma group (54% vs. 100%; p < .01). CONCLUSION: We conclude that the frequency of hospital admissions that have occurred during the preceding year was similar between subjects with current MP and MS asthma. Symptoms score and the financial values spent by the family in the care of asthma were lower in the MP asthma group.
Assuntos
Antiasmáticos , Asma , Admissão do Paciente , Administração por Inalação , Adolescente , Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Asma/epidemiologia , Criança , Hospitais , Humanos , Admissão do Paciente/estatística & dados numéricos , EspirometriaRESUMO
OBJECTIVE: To determine whether a low level of education is a risk factor for uncontrolled asthma in a population of patients who have access to pulmonologists and to treatment. METHODS: This was a cross-sectional study involving outpatients > 10 years of age diagnosed with asthma who were followed by a pulmonologist for at least 3 months in the city of Jundiai, located in the state of São Paulo, Brazil. The patients completed a questionnaire specifically designed for this study, the 6-item Asthma Control Questionnaire (to assess the control of asthma symptoms), and a questionnaire designed to assess treatment adherence. Patients underwent spirometry, and patient inhaler technique was assessed. RESULTS: 358 patients were enrolled in the study. Level of education was not considered a risk factor for uncontrolled asthma symptoms (OR = 0.99; 95% CI: 0.94-1.05), spirometry findings consistent with obstructive lung disease (OR = 1.00; 95% CI: 0.99-1.01), uncontrolled asthma (OR = 1.03; 95% CI: 0.95-1.10), or the need for moderate/high doses of inhaled medication (OR = 0.99; 95% CI: 0.94-1.06). The number of years of schooling was similar between the patients in whom treatment adherence was good and those in whom it was poor (p = 0.08), as well as between those who demonstrated proper inhaler technique and those who did not (p = 0.41). CONCLUSIONS: Among asthma patients with access to pulmonologists and to treatment, a low level of education does not appear to be a limiting factor for adequate asthma control.
Assuntos
Asma/prevenção & controle , Escolaridade , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pneumologistas , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adolescente , Adulto , Idoso , Asma/fisiopatologia , Brasil , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Espirometria , Estatísticas não Paramétricas , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
ABSTRACT Objective: To determine whether a low level of education is a risk factor for uncontrolled asthma in a population of patients who have access to pulmonologists and to treatment. Methods: This was a cross-sectional study involving outpatients > 10 years of age diagnosed with asthma who were followed by a pulmonologist for at least 3 months in the city of Jundiai, located in the state of São Paulo, Brazil. The patients completed a questionnaire specifically designed for this study, the 6-item Asthma Control Questionnaire (to assess the control of asthma symptoms), and a questionnaire designed to assess treatment adherence. Patients underwent spirometry, and patient inhaler technique was assessed. Results: 358 patients were enrolled in the study. Level of education was not considered a risk factor for uncontrolled asthma symptoms (OR = 0.99; 95% CI: 0.94-1.05), spirometry findings consistent with obstructive lung disease (OR = 1.00; 95% CI: 0.99-1.01), uncontrolled asthma (OR = 1.03; 95% CI: 0.95-1.10), or the need for moderate/high doses of inhaled medication (OR = 0.99; 95% CI: 0.94-1.06). The number of years of schooling was similar between the patients in whom treatment adherence was good and those in whom it was poor (p = 0.08), as well as between those who demonstrated proper inhaler technique and those who did not (p = 0.41). Conclusions: Among asthma patients with access to pulmonologists and to treatment, a low level of education does not appear to be a limiting factor for adequate asthma control.
RESUMO Objetivo: Avaliar se a baixa escolaridade é um fator de risco para asma não controlada em uma população de pacientes que tem acesso a um pneumologista e ao tratamento. Métodos: Estudo transversal com pacientes com diagnóstico de asma, com idade > 10 anos, acompanhados por ao menos três meses por um pneumologista em ambulatórios na cidade de Jundiaí (SP). Os indivíduos responderam a um questionário específico do estudo, ao Questionário de Controle da Asma com seis questões para avaliar o controle dos sintomas da asma e a um questionário para avaliar a adesão ao tratamento. Avaliou-se a correção no uso de dispositivos inalatórios, e os pacientes realizaram espirometria. Resultados: Foram incluídos 358 pacientes. A escolaridade não foi fator de risco para sintomas de asma não controlados (OR = 0,99; IC95%: 0,94-1,05), presença de distúrbio ventilatório obstrutivo na espirometria (OR = 1,00; IC95%: 0,99-1,01), asma não controlada (OR = 1,03; IC95%: 0,95-1,10) e necessidade de dose moderada/alta de medicações inalatórias (OR = 0,99; IC95%: 0,94-1,06). O número de anos de escolaridade foi semelhante nos grupos com e sem adesão ao tratamento (p = 0,08) e nos grupos com e sem erros na utilização do dispositivo inalatório (p = 0,41). Conclusões: Nesta amostra de pacientes com asma que têm acesso a pneumologista e tratamento, a baixa escolaridade não foi um fator limitante para o controle adequado da asma.