Sub-Optimal Compliance to Long-Term Inhalation Strategies and Poorer Health Care Outcomes Associated with Extended Tattoos in Adolescents with Mild-to-Moderate Bronchial Asthma.

IF 2 4区 医学 Q2 PEDIATRICS
Roberto W Dal Negro, Paola Turco, Massimiliano Povero
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引用次数: 0

Abstract

Background: Patients' compliance to inhalation therapy is usually sub-optimal in young asthmatics. Adolescents poorly compliant to regular anti-asthma treatments and those with tattoos (and the associated attitude) can share some personality traits and maladaptive behaviors. This relationship has not been investigated.

Objective: To assess if "extended" tattoos can predict long-term compliance to regular therapy of adolescents with mild-to-moderate asthma.

Methods: A 12-month retrospective observational investigation was conducted on non-smoker asthmatic adolescents of both genders. Patients assuming <70% of prescribed vilanterol/fluticasone furoate o.d. were defined as "non-compliant". Tattoo surfaces were defined as "mild" or "extended" if they were < or ≥400 cm2, respectively. The relationship between tattoos and compliance on the evolution of resources consumption at 6 and 12 months was assessed by generalized estimating equation (GEE) models at the first and second semester of the treatment period.

Results: It was found that 13.2% of compliant adolescents had mild tattoos, while 47.2% of non-compliant adolescents had mild-to-extended tattoos (odds ratio (OR) 6.91, 95% CI 2.49 to 19.17, p < 0.001). The mean annual adherence to treatment was 57.8% ± 10.1 SD expected doses in non-compliant subjects with "mild tattoos" (54.8 cm2 ± 36.9 SD), but 38.6% ± 11.4 SD expected doses in those with "extended tattoos" (568.4 cm2 ± 111.6 SD, p < 0.001). Total cost proved to be a linear trend from the lowest values of compliant patients with no/mild tattoos (EUR 65.22 at 6 months and EUR 33.63 at 12 months) to the highest values of non-compliant adolescents with extended tattoos (EUR 330.75 at 6 months and EUR 297.34 at 12 months).

Conclusions: Tattoo extension might be used as a reliable predictor of poor compliance and higher health care costs in adolescents with mild-to-moderate asthma. Patients characterized by poor compliance to a long-term therapeutic strategy and tattooing attitude likely share some aspects of their personality profile.

轻度至中度支气管哮喘青少年对长期吸入策略的次最佳依从性以及与长期纹身相关的较差的医疗结果
背景:青少年哮喘患者对吸入疗法的依从性通常不够理想。对常规抗哮喘治疗依从性差的青少年和有纹身(及相关态度)的青少年可能有一些共同的人格特质和不适应行为。这种关系尚未得到研究:评估 "扩展 "纹身能否预测轻度至中度哮喘青少年对常规治疗的长期依从性:对不吸烟的男女哮喘青少年进行了为期 12 个月的回顾性观察调查。患者分别为 2 岁和 3 岁。在治疗期的第一和第二学期,通过广义估计方程(GEE)模型评估了纹身和依从性对 6 个月和 12 个月资源消耗变化的影响:结果发现,13.2%的依从青少年有轻度纹身,而47.2%的非依从青少年有轻度至重度纹身(几率比(OR)6.91,95% CI 2.49至19.17,P <0.001)。有 "轻度纹身"(54.8 平方厘米 ± 36.9 SD)的不合规受试者的年平均治疗依从性为 57.8% ± 10.1 SD 预期剂量,而有 "扩展纹身"(568.4 平方厘米 ± 111.6 SD,p < 0.001)的受试者的年平均治疗依从性为 38.6% ± 11.4 SD 预期剂量。总费用呈线性趋势,无/轻度纹身患者的费用最低(6 个月为 65.22 欧元,12 个月为 33.63 欧元),而纹身扩展的青少年费用最高(6 个月为 330.75 欧元,12 个月为 297.34 欧元):纹身时间延长可作为轻度至中度哮喘青少年依从性差和医疗费用较高的可靠预测指标。患者对长期治疗策略的依从性差和纹身态度的特点可能与其性格特征的某些方面有关。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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