Screening Heroin Smokers Attending Community Drug Clinics for Change in Lung Function: A Cohort Study.
Bronchodilator Agents
/ therapeutic use
Cigarette Smoking
/ epidemiology
Cocaine Smoking
/ epidemiology
Cohort Studies
Disease Progression
Emergency Service, Hospital
/ statistics & numerical data
Female
Forced Expiratory Volume
Heroin Dependence
/ drug therapy
Hospitalization
/ statistics & numerical data
Humans
Longitudinal Studies
Lung
/ physiopathology
Male
Marijuana Smoking
/ epidemiology
Mass Screening
Middle Aged
Opiate Substitution Treatment
Primary Health Care
/ statistics & numerical data
Pulmonary Disease, Chronic Obstructive
/ epidemiology
Severity of Illness Index
Smoking, Non-Tobacco Products
/ epidemiology
Spirometry
COPD
heroin
opiate
spirometry
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
05
06
2019
revised:
21
09
2019
accepted:
04
11
2019
pubmed:
25
11
2019
medline:
21
10
2020
entrez:
25
11
2019
Statut:
ppublish
Résumé
Heroin smokers have high rates of COPD, respiratory morbidity, hospital admission, and mortality. We assessed the natural history of symptoms and lung function in this population over time. A cohort of heroin smokers with COPD was followed for 18 to 24 months. At baseline and follow-up, respiratory symptoms were measured by the Medical Research Council Dyspnea Scale (MRC) and the COPD Assessment Tool (CAT), and postbronchodilator spirometry was performed. Frequency of health-care-seeking episodes was extracted from routine health records. Parametric, nonparametric, and linear regression models were used to analyze the change in symptoms and lung function over time. Of 372 participants originally recruited, 161 were assessed at follow-up (mean age, 51.0 ± 5.3 years; 74 women [46%]) and 106 participants completed postbronchodilator spirometry. All participants were current or previous heroin smokers, and 122 (75.8%) had smoked crack. Symptoms increased over time (MRC score increased by 0.48 points per year, P < .001; CAT score increased by 1.60 points per year, P < .001). FEV Heroin smokers experience a high and increasing burden of chronic respiratory symptoms and a decline in FEV
Sections du résumé
BACKGROUND
Heroin smokers have high rates of COPD, respiratory morbidity, hospital admission, and mortality. We assessed the natural history of symptoms and lung function in this population over time.
METHODS
A cohort of heroin smokers with COPD was followed for 18 to 24 months. At baseline and follow-up, respiratory symptoms were measured by the Medical Research Council Dyspnea Scale (MRC) and the COPD Assessment Tool (CAT), and postbronchodilator spirometry was performed. Frequency of health-care-seeking episodes was extracted from routine health records. Parametric, nonparametric, and linear regression models were used to analyze the change in symptoms and lung function over time.
RESULTS
Of 372 participants originally recruited, 161 were assessed at follow-up (mean age, 51.0 ± 5.3 years; 74 women [46%]) and 106 participants completed postbronchodilator spirometry. All participants were current or previous heroin smokers, and 122 (75.8%) had smoked crack. Symptoms increased over time (MRC score increased by 0.48 points per year, P < .001; CAT score increased by 1.60 points per year, P < .001). FEV
CONCLUSIONS
Heroin smokers experience a high and increasing burden of chronic respiratory symptoms and a decline in FEV
Identifiants
pubmed: 31759961
pii: S0012-3692(19)34224-2
doi: 10.1016/j.chest.2019.11.006
pmc: PMC7078587
pii:
doi:
Substances chimiques
Bronchodilator Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
558-565Subventions
Organisme : Medical Research Council
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.
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