Social complexity negatively influences lung function in cystic fibrosis after transfer to adult care

Research output: Contribution to journalLetter

Abstract

Background: Several nongenetic factors, such as socioeconomic status, environmental exposures, and adherence have been described to have an impact on outcomes in cystic fibrosis (CF). Objective: To determine the effect of social complexity on the % predicted forced expiratory volume (ppFEV1) before and after transfer to adult care among adolescents with CF. Methods: Retrospective, single center, cohort study included all patients with CF who were transitioned into adult care between 2005 and 2015 at Indiana University. Social complexity (Bob's level of social support, [BLSS]) was collected at transfer. Linear mixed regression models assessed the relationship between ppFEV1 decline over time and BLSS with other covariates. Results: The median age of the patients (N = 133) at the time of transfer was 20 years (interquartile range: 19-23). Overall, there was a decline in lung function over time in our population (ppFEV1 at 24 months pretransfer 77 ± 20%, ppFEV1 at 24 months, posttransfer 66 ± 24%; P <.001). The relationship between BLSS and ppFEV1 became more negative over time, even after adjusting for other covariates. Conclusion: Social complexity is strongly associated with lung function decline after transfer to adult care.

Original languageEnglish (US)
JournalPediatric pulmonology
DOIs
StateAccepted/In press - Jan 1 2019

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Transition to Adult Care
Cystic Fibrosis
Social Support
Lung
Environmental Exposure
Forced Expiratory Volume
Social Class
Linear Models
Cohort Studies
Population

Keywords

  • adolescent
  • cystic fibrosis
  • social determinants of health
  • social support
  • transition to adult care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

@article{4d77589796f04a1589d2caaef83bafa1,
title = "Social complexity negatively influences lung function in cystic fibrosis after transfer to adult care",
abstract = "Background: Several nongenetic factors, such as socioeconomic status, environmental exposures, and adherence have been described to have an impact on outcomes in cystic fibrosis (CF). Objective: To determine the effect of social complexity on the {\%} predicted forced expiratory volume (ppFEV1) before and after transfer to adult care among adolescents with CF. Methods: Retrospective, single center, cohort study included all patients with CF who were transitioned into adult care between 2005 and 2015 at Indiana University. Social complexity (Bob's level of social support, [BLSS]) was collected at transfer. Linear mixed regression models assessed the relationship between ppFEV1 decline over time and BLSS with other covariates. Results: The median age of the patients (N = 133) at the time of transfer was 20 years (interquartile range: 19-23). Overall, there was a decline in lung function over time in our population (ppFEV1 at 24 months pretransfer 77 ± 20{\%}, ppFEV1 at 24 months, posttransfer 66 ± 24{\%}; P <.001). The relationship between BLSS and ppFEV1 became more negative over time, even after adjusting for other covariates. Conclusion: Social complexity is strongly associated with lung function decline after transfer to adult care.",
keywords = "adolescent, cystic fibrosis, social determinants of health, social support, transition to adult care",
author = "Crowley, {Erin M.} and Bosslet, {Gabriel T.} and Babar Khan and Mary Ciccarelli and Brown, {Cynthia D.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/ppul.24523",
language = "English (US)",
journal = "Pediatric Pulmonology",
issn = "8755-6863",
publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Social complexity negatively influences lung function in cystic fibrosis after transfer to adult care

AU - Crowley, Erin M.

AU - Bosslet, Gabriel T.

AU - Khan, Babar

AU - Ciccarelli, Mary

AU - Brown, Cynthia D.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Several nongenetic factors, such as socioeconomic status, environmental exposures, and adherence have been described to have an impact on outcomes in cystic fibrosis (CF). Objective: To determine the effect of social complexity on the % predicted forced expiratory volume (ppFEV1) before and after transfer to adult care among adolescents with CF. Methods: Retrospective, single center, cohort study included all patients with CF who were transitioned into adult care between 2005 and 2015 at Indiana University. Social complexity (Bob's level of social support, [BLSS]) was collected at transfer. Linear mixed regression models assessed the relationship between ppFEV1 decline over time and BLSS with other covariates. Results: The median age of the patients (N = 133) at the time of transfer was 20 years (interquartile range: 19-23). Overall, there was a decline in lung function over time in our population (ppFEV1 at 24 months pretransfer 77 ± 20%, ppFEV1 at 24 months, posttransfer 66 ± 24%; P <.001). The relationship between BLSS and ppFEV1 became more negative over time, even after adjusting for other covariates. Conclusion: Social complexity is strongly associated with lung function decline after transfer to adult care.

AB - Background: Several nongenetic factors, such as socioeconomic status, environmental exposures, and adherence have been described to have an impact on outcomes in cystic fibrosis (CF). Objective: To determine the effect of social complexity on the % predicted forced expiratory volume (ppFEV1) before and after transfer to adult care among adolescents with CF. Methods: Retrospective, single center, cohort study included all patients with CF who were transitioned into adult care between 2005 and 2015 at Indiana University. Social complexity (Bob's level of social support, [BLSS]) was collected at transfer. Linear mixed regression models assessed the relationship between ppFEV1 decline over time and BLSS with other covariates. Results: The median age of the patients (N = 133) at the time of transfer was 20 years (interquartile range: 19-23). Overall, there was a decline in lung function over time in our population (ppFEV1 at 24 months pretransfer 77 ± 20%, ppFEV1 at 24 months, posttransfer 66 ± 24%; P <.001). The relationship between BLSS and ppFEV1 became more negative over time, even after adjusting for other covariates. Conclusion: Social complexity is strongly associated with lung function decline after transfer to adult care.

KW - adolescent

KW - cystic fibrosis

KW - social determinants of health

KW - social support

KW - transition to adult care

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