From the female perspective: Long-term effects on quality of life of a program for women with asthma.
BACKGROUND
Although, among adults, asthma predominates in women, the role of sex and gender in asthma has only recently been studied. Moreover, only one study has focused on the management of asthma by women, reporting that 1 year subsequent to an intervention addressing sex and gender role factors, women's asthma status was improved.


OBJECTIVE
Data from a 2-year postintervention follow-up were assessed to determine whether there were longer-term effects on the asthma status and quality of life (QoL) of the participants.


METHODS
A randomized controlled design was used in which female patients with asthma, who were receiving services at the University of Michigan Health System, Ann Arbor, Michigan (2002-2006), were assigned to either a control group or a female-oriented intervention group that focused on management challenges related to sex and gender role factors. Data were collected at baseline and 2 years' postintervention (2008) by telephone interview and review of medical records. Measures included asthma-related QoL, health care and medication use for asthma, level of self-regulation, self-confidence in managing the condition, sex and gender role-related asthma problems, and days of missed work or school because of asthma. Data were analyzed using both generalized estimating equations logistic regression and log-linear regression.


RESULTS
The mean (SD) age of the 808 women participating in the study was 48.2 (13.1) years in the intervention group and 48.7 (14.3) years in the control group, and the percentage of minority participants was 15.8% and 16.3%, respectively. Despite randomization, women in the intervention group had more persistent asthma at baseline. At 2 years' postrandomization, the only significant difference in health care use was associated with scheduled office visits; no other significant health care use differences were evident. However, the women in the intervention group had a significantly greater decrease of asthma symptoms with sexual activity (P = 0.01) and greater reduction in days of work/school missed for asthma in winter months (P = 0.03), were better able to self-regulate (P = 0.01), were more confident in managing their asthma (P = 0.01), and had higher levels of asthma-related QoL (P = 0.02). They also had a greater reduction in the use of short-acting bronchodilators (ie, rescue medications) than did women in the control group (P < or = 0.05).


CONCLUSIONS
An intervention that focuses on female-specific aspects of asthma management may result in improved QoL and health status for women with asthma, as was evident 2 years' postintervention in this study.
Clark
Noreen M
NM
Center for Managing Chronic Disease, University of Michigan, Ann Arbor, 48109-2029, USA. nmclark@umich.edu
Gong
Z Molly
ZM
Wang
Si Jian
SJ
Valerio
Melissa A
MA
Bria
William F
WF
Johnson
Timothy R
TR
D000041:Absenteeism; D000328:Adult; D001249:Asthma / Q000517:prevention & control / Q000523:psychology; D001294:Attitude to Health; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003376:Counseling / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008824:Michigan; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care; D020377:Self Efficacy; D012727:Sex Characteristics; D012725:Sexual Behavior; D016037:Single-Blind Method; D013689:Telephone; D014930:Women / Q000193:education / Q000523:psychology
D001993:Bronchodilator Agents