Obstructive Sleep Apnoea and Cardiac Disease Among Aboriginal Patients in the Northern Territory of Australia

Heraganahally, Subash S.; Rajaratnam, Brinthan; Silva, Sampathawaduge A.A.S.; Robinson, Nicola; Oguoma, Victor Maduabuchi; Naing, Pyi; Kangaharan, Nadarajah; Ilton, Marcus

doi:10.1016/j.hlc.2021.01.007

Cited by 14 publications

(18 citation statements)

References 32 publications

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“…This stronger effect of disease on FEV 1 in males may be a result of the relatively reduced growth in airways compared to lung parenchyma/alveoli or alternatively due to higher smoking rates or age-related decline in FEV 1 or increasing severity of the underlying disease [2-10, 26, 31, 32]. Indigenous people have a higher burden of chronic health conditions, including cardiorespiratory disorders, giving rise to higher morbidity and mortality [33][34][35][36][37]. Understanding the different clinical manifestations [38][39][40] and appropriate interventions [41][42][43][44][45][46][47][48][49][50] will help in early diagnosis and management of chronic health conditions in the Indigenous population, for better health related outcomes.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

et al. 2022

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Background Studies assessing normative values and sex differences in pulmonary function test parameters (PFTPs) among Indigenous populations are sparse. Methods PFTPs were compared between male and female Indigenous Australian adults with and without chest radiologically proven chronic airway diseases (CADs). Results 485 adults (56% were female) with no significant difference in age, body mass index or smoking status between sexes were included. Females displayed a higher prevalence of radiology without CADs compared to males (66 vs. 52%, respectively). Among patients without CADs, after adjustment for age, stature and smoking, males displayed significantly higher absolute values of Forced Vital Capacity (FVC) (mean difference, 0.41L (0.21,0.62), p<0.001) and Forced Expiratory Volume in one second (FEV1) (mean difference 0.27L (0.07,0.47), p<0.001), with no significant difference in FEV1/FVC ratio (mean difference -0.02 (-0.06, 0.02), p = 0.174). Male and female patients with radiologically proven CADs demonstrated lower FEV1/FVC values. However, compared to females, males showed significantly greater reductions in pre- [-0.53 (-0.74, -0.32) vs. -0.29 (-0.42, -0.16), p = 0.045] and post- [-0.51 (-0.72, -0.3) vs. -0.27 (-0.39, -0.14), p = 0.049] bronchodilator FEV1. Conclusions There are significant sex differences in the PFTPs among Indigenous Australians. Recognising these differences may be of value in the accurate diagnosis, management, monitoring and prognostication of CADs in this population.

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Section: Discussionmentioning

confidence: 99%

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

et al. 2022

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“…Previous reports from our centre have shown significantly lower lung function parameters [ 25 – 27 ], even among apparently healthy Indigenous Australian individuals [ 28 ], and a higher prevalence of complex multiple respiratory comorbidities [ 17 , 20 , 21 , 29 – 31 ]. The current study portrays one aspect of the outcomes related to these epidemiological underpinnings in the population with a high relative prevalence of ED presentations, and a significantly higher proportion of multiple presentations.…”

Section: Discussionmentioning

confidence: 96%

Comparison and outcomes of emergency department presentations with respiratory disorders among Australian indigenous and non-indigenous patients

et al. 2022

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Background There is sparse evidence in the literature assessing emergency department presentation with respiratory disorders among Indigenous patients. The objective of this study was to evaluate the clinical characteristics and outcomes for Indigenous Australians in comparison to non-Indigenous patients presenting to Emergency Department (ED) with respiratory disorders. Methods In this study, two non-contiguous one-month study periods during wet (January) and dry (August) season were reported on, and differences in demographics, respiratory diagnosis, hospital admission, length of hospital stay, re-presentation to hospital after discharge and mortality between Australian Indigenous and non-Indigenous patients was assessed. Results There were a total of 528 respiratory ED presentations, 258 (49%) during wet and 270 (51%) in dry season, from 477 patients (52% female and 40% Indigenous). The majority of ED presentations (84%) were self-initiated, with a difference between Indigenous (80%) and non-Indigenous (88%) presentations. Indigenous presentations recorded a greater proportion of transfers from another healthcare facility compared to non-Indigenous presentations (11% vs. 1%). Less than half of presentations (42%) resulted in admission to the ward with no difference by Indigenous status. Lower respiratory tract infections were the most common cause of presentation (41%), followed by airway exacerbation (31%) which was more commonly seen among Indigenous (34%) than non-Indigenous (28%) presentations. Almost 20% of Indigenous patients reported multiple presentations to ED compared to 1% of non-Indigenous patients, though mortality on follow up did not differ (22% for both). Conclusions The results of this study may be an avenue to explore possibilities of implementing programs that may be helpful to reduce preventable ED presentation and recurrent hospitalisations among Indigenous population.

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“…As such, it is plausible that the current study captured anywhere from 40% to 60% of current Indigenous COPD patients in the TEHS region. More recently, several aspects of respiratory health issues among Indigenous Australians from the TEHS region of the NT has been reported in the literature 19–24 28 32 35–40 52–66. Hence, this study could be considered as an important further step forward67 in addressing COPD disease awareness and knowledge in an Indigenous population.…”

Section: Discussionmentioning

confidence: 76%

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

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BackgroundThe prevalence of chronic obstructive pulmonary disease (COPD) is higher among Indigenous Australians than that of non-Indigenous Australians. However, no studies have investigated COPD disease awareness and knowledge among Indigenous Australians. In this study, we assessed the COPD disease awareness among Indigenous and non-Indigenous patients in the Top End Health Service region of the Northern Territory of Australia.MethodsOf a total convenience sample of 100 adults, 86 patients consented to participate in this study over a 15-month period. A structured interview was conducted to identify participant’s level of knowledge about COPD, medications, self-management, healthcare interaction and utilisations.ResultsMost (69%) participants were Indigenous and men (52%). Indigenous patients were significantly younger (mean 56 vs 68 years p<0.001), with a higher proportion of remote residence and current smoking. COPD knowledge across the cohort was low, with 68% of Indigenous and 19% of non-Indigenous participants reporting they ‘know nothing/had never heard of COPD’. Most patients self-reported use of puffers/inhalers and were able to identify medication used; however, adherence to therapy was observed in only 18%. Shortness of breath was the most common symptom for hospital presentation (83%) and 69% of Indigenous patients reported seeking medical attention during an exacerbation. Self-management and COPD action plans were poorly implemented. A significant proportion (49%) reported ≥2 hospital admissions in the preceding 12 months. During exacerbation, although the majority of Indigenous patients were transferred to a tertiary centre from remote communities, patient’s preference was to be managed in their respective local communities.ConclusionsAwareness and understanding of COPD are low in this cohort on several domains. Tailored and culturally appropriate initiatives for both patients and health professionals alike are required to improve COPD disease management among Indigenous population. This will not only improve quality of life but also reduce recurrent hospitalisation, healthcare cost and utilisation.

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Obstructive Sleep Apnoea and Cardiac Disease Among Aboriginal Patients in the Northern Territory of Australia

Cited by 14 publications

References 32 publications

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

Comparison and outcomes of emergency department presentations with respiratory disorders among Australian indigenous and non-indigenous patients

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

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