scholarly journals Depression Levels Influence the Rate of Asthma Exacerbations in Females

2021 ◽  
Vol 11 (6) ◽  
pp. 586
Author(s):  
Papaporfyriou Anastasia ◽  
Tseliou Eleni ◽  
Mizi Eleftheria ◽  
Ntontsi Xenia ◽  
Papathanasiou Eygenia ◽  
...  
Keyword(s):  
Control Level ◽  
Depression Scale ◽  
Low Frequency ◽  
Anxiety And Depression ◽  
Asthmatic Patients ◽  
Asthma Exacerbations ◽  
Depression Subscale ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Global Initiative

Background: Anxiety and depression are common psychological disturbances among asthmatic patients. The aim of the present study is the assessment of anxiety and depression in asthmatic patients and their correlation with symptoms control level and number of exacerbations per year. Methods: One hundred patients with asthma diagnosis, according to the Global Initiative for Asthma (GINA), aged > 18 years old, having a stable disease, were included. Emotional status was evaluated using the Hospital Anxiety Depression Scale (HADS). Patients were followed up for a year to assess the number and severity of exacerbations. Results: Most of our patients were female (58%), middle-aged (mean = 54 ± 13), and married (81%), with low frequency of smoking habits (smokers, ex-smokers and non-smokers were 26%, 30% and 37%, respectively) and low levels of both anxiety and depression [median (interquartile range (IQR)) = 4(2) and median (IQR) = 4(2), respectively]. At the low and moderate level of the depression subscale, female patients experienced asthma exacerbations more frequently compared to male patients (adjusted Incidence Rate Ratio (aIRR) = 4.30; 95% Confidence Interval (CI): 1.94–9.53 and aIRR = 1.82; 95% CI: 1.07–3.13, respectively). Conclusions. Clinicians should evaluate asthma patients for depression, as gender differentially influences outcomes among those with low and moderate levels of depression, with female asthmatics presenting more frequent exacerbations.

scholarly journals No Differences in HADS Scores Between Acutely Concussed and Healthy Collegiate Student-Athletes

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S12.1-S12
Author(s):  
Corey Lanois ◽  
Francis Wang ◽  
Brant Berkstresser ◽  
Jessie Oldham ◽  
William Meehan ◽  
...  
Keyword(s):  
Student Athletes ◽  
Depression Scale ◽  
Collegiate Athletes ◽  
Anxiety And Depression ◽  
Post Injury ◽  
Depression Subscale ◽  
Significant Difference ◽  
Prolonged Recovery ◽  
Healthy Control ◽  
Concussion Recovery

ObjectiveTo investigate differences in Hospital Anxiety and Depression Scale (HADS) scores between acutely concussed collegiate student-athletes and healthy, matched group of collegiate athletes.BackgroundMood disturbances have been documented acutely following concussion. The presence of anxiety and/or depression may complicate and prolong concussion recovery among some athletes. Therefore, it is important to examine acute post-injury anxiety and depression to facilitate proper management decisions.Design/MethodsTwenty-six student-athletes (54% female, 19.92 ± 5.56 years of age) with a diagnosed concussion completed the HADS questionnaire within a week of injury. Twenty-six healthy student-athletes (54% female, 18.82 ± 0.54 years of age) completed the HADS during pre-season baseline testing, individually matched by sex and sport. Independent samples t-tests were used to explore differences in HADS scores between groups.ResultsThere was no significant difference (p = 0.50) between total HADS scores of the concussion group (6.77 ± 6.17) and healthy cohort (5.81 ± 3.85). There were also no significant differences between concussion and uninjured groups on the HADS Anxiety subscale (4.38 ± 4.24 vs. 4.50 ± 2.83; p = 0.91) or HADS Depression subscale (2.38 ± 2.82 vs. 1.31 ± 1.67; p = 0.10).ConclusionsHADS scores obtained among collegiate student athletes acutely following concussion did not significantly differ relative to matched healthy control participants. It is possible that one week post-injury was not enough time to observe measurable effects of anxiety or depression, as those are commonly seen in cases of prolonged recovery.

scholarly journals Overuse of reliever inhalers and associated healthcare utilization of asthma patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ronit Hadad ◽  
Diana Likhtenshtein ◽  
Nimrod Maimon ◽  
Tzahit Simon-Tuval
Keyword(s):  
Healthcare Utilization ◽  
Intervention Strategies ◽  
Ordered Logit Model ◽  
Pharmaceutical Therapy ◽  
Medication Costs ◽  
Global Initiative For Asthma ◽  
Proportion Of Days Covered ◽  
Asthma Patients ◽  
Study Population ◽  
Global Initiative

Abstract Global Initiative for Asthma 2019 guidelines recommend to avoid strengthening patients’ reliance on relievers since they increase exacerbation risk. Our aim was to examine the association between reliever inhalers overuse and all-cause healthcare utilization (HCU). A retrospective study among Clalit Health Services (CHS) adult enrollees (n = 977) for 2012–2017. Reliever inhalers overuse was defined as consistent prescription refills of ≥ 3 canisters annually. Adherence to controllers was calculated using the proportion of days covered. HCU included: hospitalizations, diagnostic and surgical procedures, medications, emergency room (ER) visits, and clinic visits. 27% of the study population (n = 264) consistently refilled ≥ 3 relievers prescriptions annually, and had higher adherence to controllers (0.38 vs. 0.24, p < 0.001). Their total 6-year HCU costs were not higher than that of others ($5,550 vs. $5,562, p = 0.107). Most HCU components [including hospitalization (p = 0.405) and ER visits (p = 0.884)] were comparable; however, medication costs were higher ($1734 vs. $1504, p < 0.001). A multivariable ordered-logit model revealed that frequent and regular use of relievers was not associated with higher HCU costs (OR = 0.82, 95% CI 0.62–1.09, p = 0.175). Higher adherence to maintenance and reliever therapy (OR = 2.18, 95% CI 1.44–3.28, p < 0.001), other controllers (OR = 3.30, 95% CI 2.11–5.16, p < 0.001), and nebulized SABAs and SAMAs (OR = 1.08, 95% CI 1.02–1.14, p = 0.007) was associated with higher costs. Overuse of reliever inhalers was prevalent and associated with higher adherence to controllers, yet not associated with higher all-cause HCU. This highlights the need to examine the sources of elevated usage in order to develop intervention strategies to optimize pharmaceutical therapy of asthma patients.

scholarly journals Epidemiology of Depression and Associated Factors among Asthma Patients in Addis Ababa, Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Mebrat Abera Woledesenbet ◽  
Shegaye Shumet Mekonen ◽  
Lamesa Melese Sori ◽  
Tadesse Melaku Abegaz
Keyword(s):  
Associated Factors ◽  
Addis Ababa ◽  
Depression Scale ◽  
Binary Logistic Regression Analysis ◽  
Uncontrolled Asthma ◽  
Asthmatic Patients ◽  
Prevalence Of Depression ◽  
Asthma Patients ◽  
Epidemiology Of Depression ◽  
Cardiac Illness

Background. Depression in asthma patients can cause worsening of respiratory symptoms. Addressing mental illness in those with asthma improves asthma outcomes. This study aimed to assess the epidemiology of depression and associated factors among asthma patients attending government hospitals in Ethiopia. Methods. Institutional based cross-sectional study was conducted on patients with asthma at three governmental hospitals of Addis Ababa from June to July 2017. Patient health questionnaire (PHQ-9) depression scale was used to assess prevalence of depression among asthmatic patients. The data were entered and analyzed using SPSS version 20 statistical software. Binary logistic regression analysis was conducted to identify associated factors for depression. To indicate the strength of association, odds ratios (OR) and 95% confidence intervals (95% CI) were used. Result. A total of 405 participants were enrolled in the study giving an overall response rate of 96%. The respondents had mean age of 54.46 and standard deviation (SD) of 10.01 years. About 273 (67.4%) were females. The prevalence of depression among asthma patients was 85 (21%). The odds of developing depression among single asthma patients were increased by 1.63 with 95% CI [1. 8, 3.493]. Depression among asthma patients who had comorbid cardiac illness was 6.2 times higher than those who do not have at CI [1.145, 24.109]. The prevalence of depression among uncontrolled asthma patients was 8 times higher than those with well-controlled asthma at CI [1.114, 19.025]. Conclusion. One-fifth of asthmatic patients were experiencing depression. Uncontrolled asthma, comorbid cardiac illness, and single patients were important predictors of depression among asthmatic patients. Proper control of asthmatic attack and cardiac illnesses is very important to reduce the burden of depression.

scholarly journals Level of asthma control and its relationship with medication use in asthma patients in Brazil

2014 ◽  
Vol 40 (5) ◽  
pp. 487-494 ◽  
Author(s):  
Josiane Marchioro ◽  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
...  
Keyword(s):  
Asthma Control ◽  
Latin American ◽  
Rescue Medication ◽  
Uncontrolled Asthma ◽  
The Past ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Global Initiative ◽  
Asthma Group

OBJECTIVE: To assess asthma patients in Brazil in terms of the level of asthma control, compliance with maintenance treatment, and the use of rescue medication. METHODS: We used data from a Latin American survey of a total of 400 asthma patients in four Brazilian state capitals, all of whom completed a questionnaire regarding asthma control and treatment. RESULTS: In that sample, the prevalence of asthma was 8.8%. Among the 400 patients studied, asthma was classified, in accordance with the Global Initiative for Asthma criteria, as controlled, partially controlled, and uncontrolled in 37 (9.3%), 226 (56.5%), and 137 (34.3%), respectively. In those three groups, the proportion of patients on maintenance therapy in the past four weeks was 5.4%, 19.9%, and 41.6%, respectively. The use of rescue medication was significantly more common in the uncontrolled asthma group (86.9%; p < 0.001). CONCLUSIONS: Our findings suggest that, in accordance with the established international criteria, asthma is uncontrolled in the vast majority of asthma patients in Brazil. Maintenance medications are still underutilized in Brazil, and patients with partially controlled or uncontrolled asthma are more likely to use rescue medications and oral corticosteroids.

scholarly journals Nebulised budesonide using a novel device in patients with oral steroid-dependent asthma

2014 ◽  
Vol 45 (5) ◽  
pp. 1273-1282 ◽  
Author(s):  
Claus Vogelmeier ◽  
Peter Kardos ◽  
Thomas Hofmann ◽  
Sebastian Canisius ◽  
Gerhard Scheuch ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Forced Expiratory Volume ◽  
Oral Steroid ◽  
Open Label ◽  
Double Blind ◽  
Novel Device ◽  
Steroid Dependent ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Global Initiative

This phase 2/3 randomised, parallel-group, placebo-controlled trial investigated oral corticosteroid (OCS)-sparing efficacy, safety and tolerability of nebulised budesonide (Bud) administered with a novel computer-controlled, compressor-driven inhalation system (AKITA) as add-on therapy to Global Initiative for Asthma step 5.Patients (18–65 years) with OCS-dependent asthma were randomised (2:1:1:1) to receive 18-week, twice-daily, double-blind treatment with AKITA inhaled corticosteroid (AICS)-Bud 1 mg, AICS-Bud 0.5 mg, AICS-placebo or open-label Bud 1 mg administered by conventional nebuliser (CN-Bud). OCS doses were tapered until week 14.199 patients started treatment. More AICS-Bud 1 mg (80.0%) than placebo-treated (62.5%) patients had daily OCS doses reduced ≥50%, with clinical stability to week 18 (one-sided p=0.02; treatment difference: 17.5% (95% CI 0.1–34.9%), two-sided p=0.04). Mean±sdforced expiratory volume in 1 s improved (from baseline to week 18) for AICS-Bud 1 mg (239±460 mL, p<0.001) and AICS-Bud 0.5 mg (126±345 mL, p=0.01) but not placebo (93±419 mL, p=0.36) or CN-Bud (137±459 mL, p=0.18). Fewer AICS-Bud 1 mg-treated patients experienced asthma exacerbations (7.5%) compared with placebo (17.5%) or CN-Bud (22.5%). All treatments were well tolerated.Budesonide applied with AKITA allowed significant meaningful OCS reduction in OCS-dependent asthma patients while improving pulmonary function and maintaining exacerbation control.

scholarly journals Depression Subscale of the Hospital Anxiety and Depression Scale applied preoperatively in spinal surgery

2012 ◽  
Vol 70 (5) ◽  
pp. 352-356 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Orlando Righesso ◽  
Alisson Roberto Teles ◽  
Natália Baseggio ◽  
Maíra Cristina Velho ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Depression Scale ◽  
Positive Likelihood Ratio ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Cronbach’S Alpha ◽  
Good Reliability ◽  
Cross Sectional ◽  
Cronbach's Alpha ◽  
Depression Subscale

OBJECTIVE: To evaluate the accuracy of the Depression Subscale of Hospital Anxiety and Depression Scale (HADS-D) in spine surgery, comparing it to Beck Depression Inventory (BDI). METHODS: In a cross-sectional study, the HADS-D and the BDI were applied to patients undergoing spine surgery for lumbar (n=139) or cervical spondylosis (n=17). Spearman correlation tests for HADS-D and BDI were applied. The internal consistency of HADS-D was estimated by Cronbach's alpha coefficient. RESULTS: According to the BDI, the prevalence of depression was of 28.8% (n=45). The Spearman r coefficient between HADS-D and BDI was 0.714 (p<0.001). Cronbach's alpha for HADS-D was 0.795. The area of the ROC curve was 0.845. Using a cutoff for HADS-D >10, there was a sensitivity of 71.1%, specificity of 95.4%, and positive likelihood-ratio of 15.78. CONCLUSIONS: HADS-D showed a strong correlation with BDI and good reliability. HADS-D is a good alternative for screening depression and assessing its severity.

scholarly journals Diagnostic evaluation of the hospital depression scale (HADS) and the Beck depression inventory II (BDI-II) in adults with congenital heart disease using a structured clinical interview: Impact of depression severity

2019 ◽  
Vol 27 (4) ◽  
pp. 381-390 ◽  
Author(s):  
Mechthild Westhoff-Bleck ◽  
Lotta Winter ◽  
Lukas Aguirre Davila ◽  
Christoph Herrmann-Lingen ◽  
Jens Treptau ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Beck Depression Inventory ◽  
Congenital Heart ◽  
Depression Scale ◽  
Area Under The Curve ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Major Depressive ◽  
Depression Subscale

Objective The purpose of this study was the diagnostic evaluation of the hospital anxiety and depression scale total score, its depression subscale and the Beck depression inventory II in adults with congenital heart disease. Methods This cross-sectional study evaluated 206 patients with congenital heart disease (mean age 35.3 ± 11.7 years; 58.3% men). Major depressive disorder was diagnosed by a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders IV and disease severity with the Montgomery–Åsberg depression rating scale. Receiver operating characteristics provided assessment of diagnostic accuracy. Youden’s J statistic identified optimal cut-off points. Results Fifty-three participants (25.7%) presented with major depressive disorder. Of these, 28 (52.8%) had mild and 25 (47.2%) had moderate to severe symptoms. In the total cohort, the optimal cut-off of values was >11 in the Beck depression inventory II, >11 in the hospital anxiety and depression scale and >5 in the depression subscale. Optimal cut-off points for moderate to severe major depressive disorder were similar. The cut-offs for mild major depressive disorder were lower (Beck depression inventory II >4; hospital anxiety and depression scale >8; >2 in its depression subscale). In the total cohort the calculated area under the curve varied between 0.906 (hospital anxiety and depression scale) and 0.93 (Beck depression inventory II). Detection of moderate to severe major depressive disorder (area under the curve 0.965–0.98) was excellent; detection of mild major depressive disorder (area under the curve 0.851–0.885) was limited. Patients with major depressive disorder had a significantly lower quality of life, even when they had mild symptoms. Conclusion All scales were excellent for detecting moderate to severe major depressive disorder. Classification of mild major depressive disorder, representing 50% of cases, was limited. Therapy necessitating loss of quality of life is already present in major depressive disorder with mild symptoms. Established cut-off points may still be too high to identify patients with major depressive disorder requiring therapy. External validation is needed to confirm our data.

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