Smoking assessment and work ability trends in asthma patients – prospective and retrospective study approach
Year: 2021
Type: dissertation
Study design: Observational Study
Abstract: Smoking increases the risk of asthma and impairs the prognosis of the disease and therapeutic response. Smoking cessation is an essential part of the treatment of asthma. The comprehensive treatment of asthma is also important for the patient’s work ability. The prevalence of asthma has grown, and an increasing number of workers have to cope with the disease in their working lives. The present study aimed to evaluate how reliably asthmatics reported their smoking status and the changes in smoking habits over the last 15 years. We investigated how actively physicians discuss and document patient’s smoking status. The study also examined the development of the work ability score (WAS) in asthma patients to find risk factors for poor development of WAS. This study included two cohorts. The Finnish obstructive airway disease (CAD) cohort included 1,329 asthma patients and 959 chronic obstructive pulmonary disease patients. Their smoking habits, work ability, and general health were followed by questionnaires during 10-years. The register-based cohort included 35,650 patients, whose electronic health records (EHR) were analysed with a combination of rule-and deep learning (ULMFiT)-based algorithms. Only 6% of asthmatics had unreliability in the self-reported smoking data. Pack years can be considered only a rough estimate of the comprehensive consumption of tobacco products. Based on the algorithmic analysis, 61% of asthma patients had documented smoking status, and 55% of current smokers had discussed smoking cessation with the clinician during the two-year follow-up. In the future, smoking cessation care should be activated in hospitals. The performance of the ULMFiT-based classifier was good and showed that deep-learning-based models can create efficient tools for utilising the Finnish EHR. Over 90% of the patients’ WAS remained stable throughout the 10-year study period, but 8% of the patients who had more severe asthma, higher BMI, and multiple comorbidities showed significantly poorer outcomes. To support asthma patients’ work ability, comprehensive treatment of asthma and comorbidities, regular controls, and weight management are needed.
Source: UTUPub (University of Turku)
Author: Hirvonen, Eveliina
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6987257943