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Change in β2-agonist use after severe life events in adults with asthma: A population-based cohort study Life events and bronchodilator usage among adults with asthma
Department of Public Health, University of Turku, Turku, Finland.
School of Health Sciences, University of Tampere, Tampere, Finland.
Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Department of Epidemiology and Public Health, University College London Medical School, London, United Kingdom.
Department of Psychiatry, University of Turku and Harjavalta Hospital, Satakunta Hospital District, Harjavalta, Finland.
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2017 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 100, 46-52 p.Article in journal (Refereed) Published
Abstract [en]

Objective: This prospective, population-based cohort study of 1102 Finnish adults with asthma, examined whether exposure to stressful life events is associated with the intensity of usage of inhaled short-acting β2- agonists. Methods: Survey data was collected by two postal questionnaires. Baseline characteristics were obtained in 1998 and data on 19 specific stressful events (e.g. death of a child or spouse or divorce) within the six preceding months in 2003. Exposure to life events was indicated by a sum score weighted by mean severity of the events. Participants were linked to records of filled prescriptions for inhaled short-acting β2-agonists from national registers from 2000 through 2006. The rates of purchases of short-acting β2-agonists before (2000−2001), during (2002−2003) and after (2004–2006) the event exposure were estimated using repeated-measures Poisson regression analyses with the generalized estimating equation. Results: Of the 1102 participants, 162 (15%) were exposed to highly stressful events, 205 (19%) to less stressful events. During the 7-year observation period, 5955 purchases of filled prescription for inhaled short-acting β2- agonists were recorded. After exposure to highly stressful events, the rate of purchases of β2-agonists was 1.50 times higher (95% confidence interval (CI): 1.05, 2.13) than before the stressful event occurred. Among those with low or no exposure to life events, the corresponding rate ratios were not elevated (rate ratio 0.81, 95% CI: 0.66, 0.99 and 0.95, 95% CI: 0.83, 1.09 respectively). Conclusion: An increase in β2-agonist usage after severe life events suggests that stressful experiences may worsen asthma symptoms

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 100, 46-52 p.
Keyword [en]
Asthma, Cohort study, Generalized estimating equation method, Life events, Short-acting beta(2)-agonists, Stressful life events
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-14116DOI: 10.1016/j.jpsychores.2017.07.003ISI: 000407873300007PubMedID: 28789792Scopus ID: 2-s2.0-85023624335OAI: oai:DiVA.org:his-14116DiVA: diva2:1141416
Available from: 2017-09-14 Created: 2017-09-14 Last updated: 2017-09-14

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