ABSTRACT
AIM: To study any discriminative properties of SF-36 and QQL-EPM in stable and non-controlled moderate asthmatic patients. METHODS: A total of 63 asthmatic patients were assessed regarding asthma symptoms, FEV1 % predicted value, PEF, ED visits and hospitalizations, QQL-EPM and SF-36 questionnaires. RESULTS: QQL-EPM highlighted significance in all domains to distinguish stable from non-controlled patients (p = 0.0001) while SF-36 was only significant in 3 of its 7 domains (p = 0.009). CONCLUSION: The study showed that the specific quality of life questionnaire for asthma (QQL-EPM) demonstrates better discriminative properties that characterize asthma control when compared with the more generic SF-36 questionnaire.
Subject(s)
Asthma/psychology , Quality of Life , Adolescent , Adult , Asthma/therapy , Female , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The purpose of the study was to observe facial and teeth alterations in adult patients with asthma as opposed to a group who suffered from hypertension. METHODS: All patients included in this cross-sectional observational study were interviewed to obtain clinical data. Patients also followed an orthodontic assessment using model-facial photographic and gypsum casts to diagnose malocclusion and dentofacial deformities. Asthmatic patients were divided in two groups according to asthma onset under or over 14 years of age. RESULTS: A total of 61 asthmatics and 53 hypertensive patients were evaluated. Dental midline symmetry was significantly lower in asthmatics than in the hypertensive group (p = 0.006), whereas incompetent lip posture and open nasal lip angle were significantly more frequent in the asthmatic group than in the control group (p = 0.007 and 0.016, respectively). Asthmatics had more dental crossbite (p = 0.004), overbite (p = 0.01), overjet (p = 0.01), smaller inter bicuspids distance (p = 0.0009) and inter molar distance (p = 0.0001) than the control group. More crowding than diastems was observed in asthmatic patients. An association between the crossbite (p = 0.02) and maxillary crowding (p = 0.03) was also observed with the earlier age of asthma onset. CONCLUSION: The findings of this study lead us to note that dentofacial anomalies are related to asthma.
Subject(s)
Asthma/complications , Facial Asymmetry/etiology , Malocclusion/etiology , Adult , Age Distribution , Asthma/diagnosis , Brazil/epidemiology , Case-Control Studies , Cross-Sectional Studies , Facial Asymmetry/epidemiology , Female , Humans , Incidence , Male , Malocclusion/epidemiology , Middle Aged , Respiratory Function Tests , Risk Assessment , Severity of Illness Index , Sex DistributionABSTRACT
INTRODUCTION: Quality-of-life questionnaires have been recognized as an important tool to measure the impact of asthma in the patient's life and has become a main outcome in clinical research. To be effective, questionnaires should be adapted to reflect the needs of the target population. OBJECTIVE: To assess the reliability, responsiveness, and cross-sectional validity of a simplified quality-of-life questionnaire (QQL-EPM) as a tool specially developed for a socioeconomically deprived target population of asthmatic patients. METHOD: Thirty-five asthma patients were followed in a prospective open study over a period of 9 weeks. Clinical visits were performed monthly with pulmonary function assessment and the patients filled out a diary card regarding symptom scores, use of rescue medication, and PEF. At each visit, FEV1 and FVC were measured and two health-related quality-of-life questionnaires were applied: general quality of life (SF-36) and specific quality of life (QQL-EPM). The condition of patient regarding asthma control was assessed at each visit to the clinic, with treatment optimization and medication adjustment as needed. At the end of the study, each period was analyzed across the trial period and classified as stable or noncontrolled asthma. RESULTS: QQL-EPM was able to correlate changes in quality of life in patients with alterations in their asthma control condition (global = 0.0001) and to differentiate these patients from those whose condition remained stable (global = 0.0001). The reliability of QQL-EPM was 0.68-0.90, and correlation with other clinical measurements and generic quality of life was moderate.
Subject(s)
Asthma/psychology , Poverty/psychology , Quality of Life/psychology , Surveys and Questionnaires , Adolescent , Adult , Asthma/physiopathology , Female , Health Status , Humans , Male , Middle Aged , Reproducibility of Results , Respiratory Function TestsABSTRACT
Introdução: A asma pouco controlada acarreta custo econômico substancial para o sistema de saúde, principalmente, decorrente de gastos diretos. Programas de educação podem levar à redução desses custos. Objetivo: Avaliar os custos econômicos diretos resultantes da implantação de um programa de educação para asmáticos quando comparado com o atendimento usual especializado. Método: Foram calculados, retrospectivamente, e comparados os custos diretos de um programa de educação e do atendimento usual ao asmático. As hospitalizações, visitas ao pronto-socorro e visitas ambulatoriais, em ambos os grupos, foram registradas durante o período da intervenção educacional. Os valores utilizados para o cálculo desses custos foram baseados nos dados disponíveis no banco de dados do Datasus de 1996. O custo total com medicação/paciente no grupo educação (E) e controle (C) foi baseado no consumo de medicação durante o mês anterior à ultima visita e estimado pelo guia farmacêutico de fevereiro de 1996. Os valores finais foram convertidos em US dólar. Resultados: O custo médio direto em US dólar por paciente (US$) dos grupos C e E e a diferença de custos (delta) entre os dois foram, respectivamente: para hospitalizações - US$183, US$0, delta = $183; visitas ao PS - US$14, US$ 5, delta = US$9; visitas ambulatoriais agendadas - US$10, US$24, delta = -US$14; medicações - US$124,3, US$195,6, delta = -US$71,3. O custo total foi de US$331 para o grupo C e US$224 para o grupo E, o que permitiu redução de gastos da ordem de US$107/paciente do grupo educação em relação ao controle. Conclusão: No grupo educação o custo total com medicamentos é superior ao observado no grupo controle, refletindo maior gasto com medicação de prevenção. Entretanto, a implantação do programa de educação leva a redução dos gastos com hospitalização e visitas ao PS, o que diminui os custos totais e torna o programa economicamente atrativo