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Trends in asthma self-management skills and inhaled corticosteroid use during pregnancy and postpartum from 2004 to 2017.
Robijn, Annelies L; Jensen, Megan E; Gibson, Peter G; Powell, Heather; Giles, Warwick B; Clifton, Vicki L; Mattes, Joerg; Peek, Michael J; Barrett, Helen L; Seeho, Sean K; Callaway, Leonie K; Abbott, Alistair; Attia, John; Wark, Peter A; Murphy, Vanessa E.
Afiliación
  • Robijn AL; a Priority Research Centre Grow Up Well, School of Medicine and Public Health , University of Newcastle, Hunter Medical Research Institute , New Lambton Heights , NSW , Australia.
  • Jensen ME; a Priority Research Centre Grow Up Well, School of Medicine and Public Health , University of Newcastle, Hunter Medical Research Institute , New Lambton Heights , NSW , Australia.
  • Gibson PG; a Priority Research Centre Grow Up Well, School of Medicine and Public Health , University of Newcastle, Hunter Medical Research Institute , New Lambton Heights , NSW , Australia.
  • Powell H; b Priority Research Centre for Healthy Lungs , University of Newcastle and Hunter Medical Research Institute , Newcastle , NSW , Australia.
  • Giles WB; c Department of Respiratory and Sleep Medicine , John Hunter Hospital , Newcastle , NSW , Australia.
  • Clifton VL; b Priority Research Centre for Healthy Lungs , University of Newcastle and Hunter Medical Research Institute , Newcastle , NSW , Australia.
  • Mattes J; c Department of Respiratory and Sleep Medicine , John Hunter Hospital , Newcastle , NSW , Australia.
  • Peek MJ; a Priority Research Centre Grow Up Well, School of Medicine and Public Health , University of Newcastle, Hunter Medical Research Institute , New Lambton Heights , NSW , Australia.
  • Barrett HL; d Department of Mothers', Babies and Women's Health , Mater Research Institute-University of Queensland, Translational Research Institute , South Brisbane , QLD , Australia.
  • Seeho SK; a Priority Research Centre Grow Up Well, School of Medicine and Public Health , University of Newcastle, Hunter Medical Research Institute , New Lambton Heights , NSW , Australia.
  • Callaway LK; e Peadiatric Respiratory and Sleep Medicine Department , John Hunter Children's Hospital , Newcastle , NSW , Australia.
  • Abbott A; f ANU Medical School, College of Health and Medicine , The Australian National University , Garran , ACT , Australia.
  • Attia J; g Chronic Disease Biology and Care, Mater Research Institute , University of Queensland , Brisbane , QLD , Australia.
  • Wark PA; h Department of Endocrinology , Mater Adult Hospital, Mater Health Services , Brisbane , QLD , Australia.
  • Murphy VE; i Department of Obstetrics and Gynaecology , Sydney Medical School Northern, University of Sydney, Royal North Shore Hospital , St Leonards, Sydney , NSW , Australia.
J Asthma ; 56(6): 594-602, 2019 06.
Article en En | MEDLINE | ID: mdl-29716412
OBJECTIVE: Asthma exacerbations and medication non-adherence are significant clinical problems during pregnancy. While asthma self-management education is effective, the number of education sessions required to maximise asthma management knowledge and inhaler technique and whether improvements persist postpartum, are unknown. This paper describes how asthma knowledge, skills, and inhaled corticosteroid (ICS) use have changed over time. METHODS: Data were obtained from 3 cohorts of pregnant women with asthma recruited in Newcastle, Australia between 2004 and 2017 (N = 895). Medication use, adherence, knowledge, and inhaler technique were compared between cohorts. Changes in self-management knowledge/skills and women's perception of medication risk to the fetus were assessed in 685 women with 5 assessments during pregnancy, and 95 women who had a postpartum assessment. RESULTS: At study entry, 41%, 29%, and 38% of participants used ICS in the 2004, 2007, and 2013 cohorts, respectively (p = 0.017), with 40% non-adherence in each cohort. Self-management skills of pregnant women with asthma did not improve between 2004 and 2017 and possession of a written action plan remained low. Maximum improvements were reached by 3 sessions for medications knowledge and one session for inhaler technique, and were maintained postpartum. ICS adherence was maximally improved after one session, but not maintained postpartum. Perceived risk of asthma medications on the fetus was highest for corticosteroid-containing medication; and was significantly reduced following education. CONCLUSIONS: There was a high prevalence of non-adherence and poor self-management skills in all cohorts. More awareness of the importance of optimal asthma management during pregnancy is warranted, since no improvements were observed over the past decade.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Complicaciones del Embarazo / Asma / Corticoesteroides / Periodo Posparto / Automanejo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Asthma Año: 2019 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Complicaciones del Embarazo / Asma / Corticoesteroides / Periodo Posparto / Automanejo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Asthma Año: 2019 Tipo del documento: Article País de afiliación: Australia