取暖券对慢性阻塞性肺病患者健康结局的影响:一项随机对照试验

IF 2.7 3区 医学 Q2 RESPIRATORY SYSTEM
Helen Elizabeth Viggers, Tristram Richard Ingham, Ralph Brougham Chapman, Julian Crane, Ann Beatrice Currie, Cheryl Davies, Michael Keall, Philippa Lynne Howden-Chapman
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引用次数: 0

摘要

目的:按照国际标准,新西兰奥特罗阿的房屋很冷,许多房屋未能达到世卫组织住房和健康指南建议的温度。尽管有强有力的证据表明慢性阻塞性肺疾病(COPD)的季节性恶化,但很少有关于家庭温度或住房质量对COPD结局的影响的研究。新西兰老年人温暖之家(WHEZ)的研究旨在了解补贴电费是否会改善患有慢性阻塞性肺病的老年人的健康状况。先前的分析显示,受补贴家庭的用电量通常有2-10%的适度增长,这取决于以前的使用情况。患者和方法:从三个区域中心招募年龄超过55岁的医生诊断为COPD的参与者,并且在入组后尽可能将其住所隔离。在新西兰的三个地方进行了一项单盲随机对照试验,研究冬季用电券(500新西兰元)对医疗保健使用的影响。主要结局是用抗生素和/或皮质类固醇治疗病情加重。临床试验注册号为NCT01627418。在520名参与者中,有424人获得了部分或更好的数据;其中215人被随机分配到早期干预组,209人稍后接受干预。结果:尽管先前报道的研究家庭的能源使用适度增加,但研究组之间COPD恶化频率(0.089,p=0.5875, 95% CI -1.406-1.584)和住院率没有显着差异。一项探索性分析表明,首先接受干预的参与者死亡率较低(OR 0.310, p=0.0175, 95% CI 0.118-0.815)。结论:本研究显示冬季用电券对COPD急性加重的影响不大。然而,这种代金券增加了能源使用,并可能降低了总体死亡率。建议进行更大规模的研究,特别是针对易感亚群的研究,以进一步检查这种死亡率影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of a Heating Voucher on Health Outcomes in COPD Patients: A Randomised Controlled Trial.

Purpose: Aotearoa New Zealand (NZ) homes are cold by international standards, with many failing to achieve temperatures recommended by WHO housing and health guidelines. Despite strong evidence of seasonal exacerbations in Chronic Obstructive Pulmonary Disease (COPD), there has been little examination of the effect of household warmth, or housing quality on COPD outcomes. The Warm Homes for Elder New Zealanders (WHEZ) study aimed to see if subsidising electricity costs would improve the health outcomes of older people with COPD. Previous analysis showed a modest, typically 2-10% dependent on prior usage, increase in electricity use among the subsidised households.

Patients and methods: Participants aged over 55 with doctor-diagnosed COPD were recruited from three regional centres, and where possible their dwelling was insulated after enrolment. A single-blinded randomised controlled trial of the effect of an electricity voucher (NZ$500) on health care usage during winter was carried out in three locations across New Zealand. The primary outcome was exacerbations treated with antibiotics, and/or corticosteroids. The Clinical Trial Registration is NCT01627418. Of the 520 participants assigned to a wave, partial or better data was achieved for 424; 215 of those were randomised to the early intervention group, and 209 to receive the intervention later.

Results: Despite the modest increase in energy use by study households, reported previously, there was no significant difference between study arms in the frequency of exacerbation of COPD (0.089, p=0.5875, 95% CI -1.406-1.584) nor hospitalisations. An exploratory analysis suggested a lower mortality among participants assigned to receive the intervention first (OR 0.310, p=0.0175, 95% CI 0.118-0.815).

Conclusion: This study showed little effect of winter electricity vouchers on exacerbations of COPD. However, such vouchers increased energy use and may have reduced overall mortality. A larger study, particularly with susceptible subpopulations, is recommended to examine this mortality impact further.

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来源期刊
CiteScore
4.80
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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