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Albuterol Overuse: A Marker of Psychological Distress?

ABSTRACT: Albuterol overuse, 3 or more canisters per year, is associated with poor asthma control and frequent exacerbations.To describe albuterol use on symptom and symptom-free days and identify predictors of albuterol overuse and controller medication underuse.Secondary analyses of data from adults with mild asthma from the Trial of Asthma Patient Education were carried out. Based on albuterol use of 80% or more on symptom days and less than 20% on symptom-free days, participants were characterized as expected users, overusers, or underusers of albuterol. Good controller medication adherence was defined as 80% or more of prescribed doses. Data included demographic characteristics, diary data, spirometry, and scores from standardized questionnaires. Bivariate associations were examined between categorization of medication use and measured characteristics.Of the 416 participants, 212 (51%) were expected users, 114 (27%) were overusers, and 90 (22%) were underusers of albuterol. No differences were observed among the user groups by demographic characteristics or lung function. Expected users demonstrated the highest asthma-related knowledge, attitudes, and efficacy. Overusers reported the greatest symptom burden, worst asthma control, and highest frequency of symptom days. Overusers also had the highest burden of depression symptoms. More frequent symptom days accounted for 15% of overuse, greater use on symptom days accounted for 31%, and greater use on symptom free days accounted for 54% of overuse. Mean controller adherence was high across all groups, and there were no differences between the groups.Although overusers experienced more frequent symptom days and used more albuterol on those days, most overuse was attributable to unexpected use on symptom-free days. High levels of comorbid depression were observed, particularly among overusers and among those nonadherent to controller medication.

SUBMITTER: Gerald JK

PROVIDER: S-EPMC4641773 | biostudies-literature | 2015 Nov-Dec

REPOSITORIES: biostudies-literature

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Albuterol Overuse: A Marker of Psychological Distress?

Gerald Joe K JK Carr Tara F TF Wei Christine Y CY Holbrook Janet T JT Gerald Lynn B LB

The journal of allergy and clinical immunology. In practice 20150901 6

<h4>Background</h4>Albuterol overuse, 3 or more canisters per year, is associated with poor asthma control and frequent exacerbations.<h4>Objective</h4>To describe albuterol use on symptom and symptom-free days and identify predictors of albuterol overuse and controller medication underuse.<h4>Methods</h4>Secondary analyses of data from adults with mild asthma from the Trial of Asthma Patient Education were carried out. Based on albuterol use of 80% or more on symptom days and less than 20% on s ...[more]

PMID: 26341049

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Project description:BackgroundPsychological distress is common among infertility patients. Total scale scores are often used to represent the severity of anxiety, depression, or stress, which ignores important differences between specific symptoms, and relationships between symptoms. This study aimed to identify patterns of psychological distress experienced by infertility patients and to identify the most central symptoms of anxiety, depression, and stress.MethodFrom June to September 2016, 740 infertility patients were included in this cross-sectional study. Infertility patients were asked to complete the Generalized Anxiety Disorder-7, Patients Health Questionnaire-9 (PHQ-9), and Fertility Problem Inventory. Network analysis was used to examine the patterns of psychological distress in infertility patients and to test the most central symptoms of anxiety, depression, and stress.ResultsRestlessness was the most central symptom in infertility patients. "Feelings of guilt" had the highest strength among PHQ-9 symptoms. "Relationship concern stress" and "sexual concern stress" had the strongest connections in the network. Stability estimation indicated that the order of node strength centrality was more stable than the order of closeness and betweenness (the CS-coefficients were 0.75, 0.13, and 0.67, respectively). In addition, network structure and global strength were invariant across gender.LimitationsThe cross-sectional design did not permit identification of causal relationships. Patients in this study were recruited from one reproductive hospital; especially, most patients had low socioeconomic status, which limits generalizability of the findings.ConclusionThis study reinforces the need to better understand the underlying causes of psychological distress in infertile patients. A more detailed investigation of the relationship between these symptoms could provide information for psychosocial interventions aimed beyond "alleviating psychological distress." We should consider the individual psychological symptom pattern and its potential causes in infertility patients instead of assuming a consistent psychological distress structure.

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Albuterol Overuse: A Marker of Psychological Distress?

Publications

Albuterol Overuse: A Marker of Psychological Distress?

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