Browsing by Author "Pascoal, Adriana dos Santos"
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- Characterization of elderly and non-elderly patients with bronchial asthmaPublication . Pascoal, Adriana dos Santos; Barata, Luís Manuel Taborda; Gama, Jorge Manuel dos ReisBackground: It is clear that health literacy, namely having knowledge about one’s own disease (self-knowledge of the disease) and its management, is fundamental for reducing the impact of bronchial asthma, namely in terms of a patient’s asthma control and quality of life. Thus, the aims of the present study were to analyze the relevance and gaps of self-knowledge about asthma in the asthmatic patient; to evaluate whether having asthma affects the level of self-knowledge of the disease and which factors may be associated with poorer selfknowledge about asthma and, finally, whether this is different in the elderly versus younger asthmatic patients. Methods: Cross-sectional assessment of 92 elderly and 100 non-elderly asthmatic patients followed at Centro Hospitalar Cova da Beira, Portugal, with a control group of 100 elderly and 100 non-elderly non asthmatic patients. All volunteers signed a written informed consent form. Standardized and validated questionnaires were applied in order to evaluate depression, cognitive state, asthma control, quality of life, knowledge about the disease, and inhaler technique demonstration was also requested. Results were analysed using the Software Package for Social Sciences®, version 23.0. Results: All four groups had a clear predominance of women. Most elderly asthmatics and non-elderly asthmatics had no depressive humor on the GDS and on the CES-D, respectively. The majority had adult-onset / late-onset (AOA/LOA) asthma. Elderly asthmatic were mostly non-atopic whereas non-elderly asthmatics were preferentially atopic. More than two thirds had their asthma controlled in the past month, as assessed by ACT. Asthmatic patients significantly demonstrated a better knowledge level than non-asthmatic volunteers. Elderly Asthmatics had similar scores to those obtained by Non-Elderly Asthmatics for all four topics of the questionnaire. The elderly asthmatic patients with no depressive mood had a significantly higher level of self-knowledge than elderly asthmatic patients with depressive mood. Conclusions: We have confirmed that elderly asthmatic patients who are preferentially female, non-atopic, have LOA/AOA and are regularly follow up at specialty clinics can demonstrate similar results in self-knowledge score to those in non-elderly asthmatics. We also showed that depression is a significant negative factor influencing self-knowledge score in elderly asthmatic patients.
- Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patientsPublication . Ferreira, Eduardo Freitas; Pascoal, Adriana dos Santos; Silva, Patrícia; Lourenço, Olga; Valente, Maria La Salete; Valente, Maria de Jesus; Loureiro, Marli; Gama, Jorge; Fonseca, Joao A; Taborda Barata, LuisObjective: Incorrect inhaler usage is frequent, particularly in elderly asthmatic patients. This study aimed at comparing inhaler technique errors and their determinants, as well inhaler technique self-perception versus real performance, between elderly and non-elderly asthmatics. Methods: Cross-sectional assessment of 92 elderly and 100 non-elderly asthmatics followed at specialty clinics. A standardized questionnaire was applied and inhaler technique demonstration was requested. Errors were assessed using checklists based on manufacturers’ instructions and inhaler technique was graded as correct, acceptable or incorrect. Chi-Square Test and Fischer’s Exact Test were used for comparative analysis of nominal variables. A p value equal to or less than 0.05 was considered statistically significant. Results: Inhaler technique was correct in a minority of elderly and young patients, without significant differences between study groups. Only 11.1% of the elderly who classified their inhaler as easy and 12.7% who stated their technique was correct had no errors. Previous regular inhaler training was associated with better actual performance in young but not in elderly patients. Conclusion: Our study showed that in spite of regular follow up at specialized outpatient clinics, inhaler devices are associated with a high frequency of errors in elderly and non-elderly asthmatics. In addition, most patients tend to overestimate their technique as correct. Finally, previous, frequent training was associated with a significantly higher percentage of patients showing correct or acceptable technique but only in non-elderly asthmatics, which suggests that elderly asthmatics may need specifically tailored inhaler education programs.