scholarly journals Linkage of Maternal Caregiver Smoking Behaviors on Environmental and Clinical Outcomes of Children with Asthma: A Post-Hoc Analysis of a Financial Incentive Trial Targeting Reduction in Pediatric Tobacco Smoke Exposures

Author(s):  
Mandeep S. Jassal ◽  
Cassia Lewis-Land ◽  
Richard E. Thompson ◽  
Arlene Butz

(1) Background: Monthly variability in smoking behaviors in caregivers of pediatric asthmatics yields questions of how much and when does smoking reduction result in improved environmental and clinical outcomes. (2) Methods: Post hoc analysis of data from a 6 month pilot randomized-control trial occurring from May 2017 to May 2018 in Baltimore City (MD, USA). The initial trial’s primary intervention explored the utility of financial incentives in modifying caregiver smoking behaviors. Post hoc analyses examined all dyads independent of the initial trial’s randomization status. All caregivers received pediatric tobacco smoke harm reduction education, in addition to monthly encouragement to access the state tobacco quitline for individual phone-based counseling and nicotine replacement therapy. Maternal caregivers who were active cigarette smokers and their linked asthmatic child (aged 2–12 years) were grouped into two classifications (“high” versus “low”) based on the child and caregiver’s cotinine levels. A “low” cotinine level was designated by at least a 25% reduction in cotinine levels during 3 months of the trial period; achieving ≤2 months of low cotinine levels defaulted to the “high” category. Twenty-seven dyads (caregivers and children) (total n = 54) were assigned to the “high” category, and eighteen dyads (caregivers and children) (total n = 36) were allocated to the “low” category. The primary outcome measure was the correlation of caregiver cotinine levels with pediatric cotinine values. Secondary outcomes included asthma control, in addition to caregiver anxiety and depression. (3) Results: Caregivers with 3 months of ≥25% decrease in cotinine levels had a significantly greater mean change in child cotinine levels (p = 0.018). “Low” caregiver cotinine levels did not significantly improve pediatric asthma control (OR 2.12 (95% CI: 0.62–7.25)). Caregiver anxiety and depression outcomes, measured by Patient Health Questionnaire (PHQ)-4 scores, was not significantly different based on cotinine categorization (p = 0.079); (4) Conclusion: Reduced pediatric cotinine levels were seen in caregivers who reduced their smoking for at least 3 months, but clinical outcome measures remained unchanged.

2020 ◽  
Vol 16 (10) ◽  
pp. 833-841
Author(s):  
Nicolas M. Van Mieghem ◽  
Michael J. Reardon ◽  
Steven J. Yakubov ◽  
John Heiser ◽  
William Merhi ◽  
...  

Author(s):  
Robert Palmér ◽  
Joachim Almquist ◽  
Mahdi Hashemi ◽  
Ziad Taib ◽  
Sofia Necander ◽  
...  

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16529-e16529
Author(s):  
Dominic Pilon ◽  
Ajay S. Behl ◽  
Rhiannon Kamstra, ◽  
Yongling Xiao ◽  
Marie-Helene Lafeuille ◽  
...  

e16529 Background: A post-hoc analysis of COU-AA-302 trial data showed that brief pain inventory (BPI), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and bone metastases were predictors for overall survival in men with mCRPC treated with AA+P. This study aimed to identify baseline predictors of other clinical outcomes. Methods: COU-AA-302 trial data were used to develop predictive models for prostate-specific antigen (PSA) progression, Eastern Cooperative Oncology Group performance status (ECOG PS) deterioration, and opiate use. Associations between baseline factors and outcomes were first assessed using multivariable Cox models among AA+P patients (Step 1). In Step 2, interaction testing was conducted between treatment (AA+P vs. placebo) and each potential predictor (P < 0.2) identified in Step 1. Final Cox models included predictors and any significant interactions (p < 0.05). Results: A total of 1,034 men (525 AA+P; 509 placebo) were included in the analysis. Baseline BPI, PSA, LDH, and ALP were predictors of PSA progression and opiate use regardless of AA+P or placebo with higher values indicating higher risks (all P < 0.05). Younger age, shorter time from luteinizing hormone-releasing hormone to randomization, higher Gleason score, and lower PSA at diagnosis were also associated with higher risks of opiate use: (all P < 0.05). For ECOG PS deterioration, higher baseline BPI, PSA, LDH, and Gleason score, older age, and lower baseline ECOG were associated with higher risks regardless of AA+P or placebo (all P < 0.05). Baseline ALP and site of metastasis also predicted ECOG PS deterioration but the effect varied by treatment (lower risk in AA+P versus placebo; both interactions’ P < 0.05). Conclusions: Predictors of PSA progression, ECOG PS deterioration, and opiate use were identified in AA+P and placebo-treated men with mCRPC. No predictors were associated with worse outcomes for AA+P versus placebo, while the negative impact of certain predictors on ECOG PS was favorably modified by AA+P. Further study is needed on the relationship between AA+P and prognostic factors.


2012 ◽  
Vol 107 ◽  
pp. S674-S675 ◽  
Author(s):  
William Sandborn ◽  
Jean-Frederic Colombel ◽  
Matthieu Allez ◽  
Jean-Louis Dupas ◽  
Olivier Dewit ◽  
...  

2019 ◽  
Vol 126 (2) ◽  
pp. S141
Author(s):  
Gere Sunder-Plassmann ◽  
Ana Jovanovic ◽  
Ulla Feldt-Rasmussen ◽  
Vipul Jain ◽  
Markus Peceny ◽  
...  

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