Effect of depressive symptoms on asthma intervention in urban teens

Lokesh Guglani, Suzanne L. Havstad, Christine Cole Johnson, Dennis Randall Ownby, Christine L.M. Joseph

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The literature suggests that depression is an important comorbidity in asthma that can significantly influence disease management and quality of life (QOL). Objective: To study the effect of coexisting depressive symptoms on the effectiveness of self-management interventions in urban teens with asthma. Methods: We analyzed data from a randomized controlled trial of Puff City, a web-based, tailored asthma management intervention for urban teens, to determine whether depression modulated intervention effectiveness for asthma control and QOL outcomes. Teens and caregivers were classified as depressed based on responses collected from baseline questionnaires. Result: Using logistic regression analysis, we found that a lower percentage of treatment students had indicators of uncontrolled asthma compared with controls (adjusted odds ratios <1). However, for teens depressed at baseline, QOL scores at follow-up were significantly higher in the treatment group compared with the control group for the emotions domain (adjusted relative risk, 2.08; 95% confidence interval, 1.2-3.63; P =.01; interpreted as emotional QOL for treatment students increased by a factor of 2.08 above controls). Estimates for overall QOL and symptoms QOL were borderline significant (adjusted relative risk, 1.57; 95% confidence interval, 0.93-2.63; P =.09; and adjusted relative risk, 1.72; 95% confidence interval, 0.94-3.15; P =.08; respectively). Among teens not depressed at baseline, no significant differences were observed between treatment and control groups in QOL domains at follow-up. Conclusion: Our results suggest that depression modified the relationship between the effectiveness of an asthma intervention and emotional QOL in urban teens. Further assessment of self-management behavioral interventions for asthma should explore the mechanism by which depression may alter the intervention effect. Trial Registration: clinicaltrials.gov Identifier: NCT00201058.

Original languageEnglish (US)
Pages (from-to)237-242.e2
JournalAnnals of Allergy, Asthma and Immunology
Volume109
Issue number4
DOIs
StatePublished - Jan 1 2012

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Asthma
Quality of Life
Depression
Confidence Intervals
Self Care
Students
Control Groups
Therapeutics
Disease Management
Caregivers
Comorbidity
Emotions
Randomized Controlled Trials
Logistic Models
Odds Ratio
Regression Analysis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Effect of depressive symptoms on asthma intervention in urban teens. / Guglani, Lokesh; Havstad, Suzanne L.; Johnson, Christine Cole; Ownby, Dennis Randall; Joseph, Christine L.M.

In: Annals of Allergy, Asthma and Immunology, Vol. 109, No. 4, 01.01.2012, p. 237-242.e2.

Research output: Contribution to journalArticle

Guglani, Lokesh ; Havstad, Suzanne L. ; Johnson, Christine Cole ; Ownby, Dennis Randall ; Joseph, Christine L.M. / Effect of depressive symptoms on asthma intervention in urban teens. In: Annals of Allergy, Asthma and Immunology. 2012 ; Vol. 109, No. 4. pp. 237-242.e2.
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AB - Background: The literature suggests that depression is an important comorbidity in asthma that can significantly influence disease management and quality of life (QOL). Objective: To study the effect of coexisting depressive symptoms on the effectiveness of self-management interventions in urban teens with asthma. Methods: We analyzed data from a randomized controlled trial of Puff City, a web-based, tailored asthma management intervention for urban teens, to determine whether depression modulated intervention effectiveness for asthma control and QOL outcomes. Teens and caregivers were classified as depressed based on responses collected from baseline questionnaires. Result: Using logistic regression analysis, we found that a lower percentage of treatment students had indicators of uncontrolled asthma compared with controls (adjusted odds ratios <1). However, for teens depressed at baseline, QOL scores at follow-up were significantly higher in the treatment group compared with the control group for the emotions domain (adjusted relative risk, 2.08; 95% confidence interval, 1.2-3.63; P =.01; interpreted as emotional QOL for treatment students increased by a factor of 2.08 above controls). Estimates for overall QOL and symptoms QOL were borderline significant (adjusted relative risk, 1.57; 95% confidence interval, 0.93-2.63; P =.09; and adjusted relative risk, 1.72; 95% confidence interval, 0.94-3.15; P =.08; respectively). Among teens not depressed at baseline, no significant differences were observed between treatment and control groups in QOL domains at follow-up. Conclusion: Our results suggest that depression modified the relationship between the effectiveness of an asthma intervention and emotional QOL in urban teens. Further assessment of self-management behavioral interventions for asthma should explore the mechanism by which depression may alter the intervention effect. Trial Registration: clinicaltrials.gov Identifier: NCT00201058.

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