Is a low level of education a limiting factor for asthma control in a population with access to pulmonologists and to treatment?

J Bras Pneumol. 2019 Feb 11;45(1):e20180052. doi: 10.1590/1806-3713/e20180052.
[Article in English, Portuguese]

Abstract

Objective: To determine whether a low level of education is a risk factor for uncontrolled asthma in a population of patients who have access to pulmonologists and to treatment.

Methods: This was a cross-sectional study involving outpatients > 10 years of age diagnosed with asthma who were followed by a pulmonologist for at least 3 months in the city of Jundiai, located in the state of São Paulo, Brazil. The patients completed a questionnaire specifically designed for this study, the 6-item Asthma Control Questionnaire (to assess the control of asthma symptoms), and a questionnaire designed to assess treatment adherence. Patients underwent spirometry, and patient inhaler technique was assessed.

Results: 358 patients were enrolled in the study. Level of education was not considered a risk factor for uncontrolled asthma symptoms (OR = 0.99; 95% CI: 0.94-1.05), spirometry findings consistent with obstructive lung disease (OR = 1.00; 95% CI: 0.99-1.01), uncontrolled asthma (OR = 1.03; 95% CI: 0.95-1.10), or the need for moderate/high doses of inhaled medication (OR = 0.99; 95% CI: 0.94-1.06). The number of years of schooling was similar between the patients in whom treatment adherence was good and those in whom it was poor (p = 0.08), as well as between those who demonstrated proper inhaler technique and those who did not (p = 0.41).

Conclusions: Among asthma patients with access to pulmonologists and to treatment, a low level of education does not appear to be a limiting factor for adequate asthma control.

Objetivo:: Avaliar se a baixa escolaridade é um fator de risco para asma não controlada em uma população de pacientes que tem acesso a um pneumologista e ao tratamento.

Métodos:: Estudo transversal com pacientes com diagnóstico de asma, com idade > 10 anos, acompanhados por ao menos três meses por um pneumologista em ambulatórios na cidade de Jundiaí (SP). Os indivíduos responderam a um questionário específico do estudo, ao Questionário de Controle da Asma com seis questões para avaliar o controle dos sintomas da asma e a um questionário para avaliar a adesão ao tratamento. Avaliou-se a correção no uso de dispositivos inalatórios, e os pacientes realizaram espirometria.

Resultados:: Foram incluídos 358 pacientes. A escolaridade não foi fator de risco para sintomas de asma não controlados (OR = 0,99; IC95%: 0,94-1,05), presença de distúrbio ventilatório obstrutivo na espirometria (OR = 1,00; IC95%: 0,99-1,01), asma não controlada (OR = 1,03; IC95%: 0,95-1,10) e necessidade de dose moderada/alta de medicações inalatórias (OR = 0,99; IC95%: 0,94-1,06). O número de anos de escolaridade foi semelhante nos grupos com e sem adesão ao tratamento (p = 0,08) e nos grupos com e sem erros na utilização do dispositivo inalatório (p = 0,41).

Conclusões:: Nesta amostra de pacientes com asma que têm acesso a pneumologista e tratamento, a baixa escolaridade não foi um fator limitante para o controle adequado da asma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asthma / physiopathology
  • Asthma / prevention & control*
  • Brazil
  • Cross-Sectional Studies
  • Educational Status*
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Pulmonologists*
  • Risk Factors
  • Severity of Illness Index
  • Spirometry
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Adherence and Compliance / statistics & numerical data*
  • Treatment Outcome
  • Young Adult