Smoking status, disease duration, and educational level in females, are related to asthma school participation

Abstract

Limited data is available on those who do not want to attend an asthma school. Two hundred and forty-five asthmatics aged 18±65 yrs with an FEV1 >50% predicted who had been seen at our outpatient asthma clinic within the last 3 yrs were invited to participate in an asthma school. The patients were contacted by phone by a nurse, offered a 2 day asthma school without personal costs.Altogether 78% of those contacted answered positively. In a logistic regression analysis including sex, age, smoking status, educational level, asthma duration and own opinion of the disease, the-adjusted odds ratio (OR) for nonsmokers wanting to participate versus smokers was 4.0 (95% confidence interval (CI): 1.8±8.3). The corresponding figure for patients with a recent asthma attack was 3.4 (95% CI: 1.5±7.6) compared to those without. For every 10 yr duration of disease the OR for wanting to take part in the asthma school increased by 1.6 (95% CI: 1.0±2.3). When analysing males and females separately, highly educated females were less willing to take part, while an opposite tendency was present in males.In conclusion those interested in taking part in an asthma school were characterized by highly motivated nonsmokers with long duration of disease and with a recent asthma attack, and not being highly educated females. Eur Respir J 2000; 15: 1022±1025. [20,21].An Australian study [20] invited asthmatics aged 15±65 yrs still hospitalized after an asthma attack, to attend an education programme of 2.5 h. Of the eligible subjects only 31% attended and completed the education. Nonattenders were characterized by male sex, being smokers and having a low socioeconomic status. In another Australian survey [21] based on out-clinic patients, a response rate of only 43% was obtained. Nonattenders were characterized by younger age.Little is known about nonparticipants of asthma schools in Europe [17]. Comparison of attenders and nonattenders in asthma schools is important in determining to whom the study results from these programmes can be applied. In the present study, asthmatics from an outpatient clinic were invited to participate in an asthma school. The objectives of the present report were to compare, by sociodemographic and respiratory variables, those who wanted to participate and those who did not want to take part in the asthma school. Subjects and methodsSubjects eligible for the study were those fulfilling the following criteria: they were aged 18±65 yrs; had received a diagnosis of asthma at the outpatient clinic of the Dept of Thoracic Medicine during the last 3 yrs prior to the study; and finally their forced expiratory volume in one second (FEV1) was >50% of predicted [22] at their last visit to the out patient clinic. Excluded were those who lived >2 h of travelling away from the clinic, and who had other serious diseases than asthma that might influence the study results. Altogether, 245 patients fulfilled the criteria. They were phoned by one of five nurses, each nurse phoned 38±55 patients. Only four subjects were n...

Exposure to environmental tobacco smoke among children presenting to the emergency department with acute asthma: A multicenter study

“…Unexpectedly they also found a decreased number of hospitalizations in the group of children with the highest cotinine level. 45 Among adults with asthma, current smokers have been found less likely to manage both acute and chronic asthma appropriately, 46,47 less likely to attend asthma education sessions, 5,[48][49][50] and overall less likely to use preventive healthcare services. 51 Our group also found that current smoking, less than HS education, and lower household income were predictors for lack of asthma knowledge and self-management skills.…”

Asthma and cigarette smoking

“…A community-based study in the UK found that smokers with chronic asthma were less likely than nonsmokers to use inhaled corticosteroids or peak flow meters, and to alter treatment during an exacerbation [47]. Smokers with asthma are less likely to attend asthma education programmes [49][50][51]. In an outpatient-based study of 125 asthmatics adults, only 4% of smokers, compared with 31% of former smokers and 65% of never-smokers, completed an asthma education programme [49].…”