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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

Lietzén, R; Virtanen, P; Kivimäki, M; Korkeila, J; Suominen, S; Sillanmäki, L; Koskenvuo, M; (2017) 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. Journal of Psychosomatic Research , 100 pp. 46-52. 10.1016/j.jpsychores.2017.07.003. Green open access

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Abstract

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.

Type: Article
Title: 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
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jpsychores.2017.07.003
Publisher version: https://doi.org/10.1016/j.jpsychores.2017.07.003
Language: English
Additional information: Copyright © 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Keywords: Asthma; Cohort study; Generalized estimating equation method; Life events; Short-acting β2-agonists; Stressful life events
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/1567615
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