Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland

Andrew J. Collaro; Anne B. Chang; Julie M. Marchant; Mark D. Chatfield; Annette Dent; Tamara Blake; Patsi Mawn; Kwun Fong; Margaret S. McElrea

doi:10.1007/s00408-021-00453-7

Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland

Andrew J. Collaro, Anne B. Chang, Julie M. Marchant, Mark D. Chatfield, Annette Dent, Tamara Blake, Patsi Mawn, Kwun Fong, Margaret S. McElrea

Child and Maternal Health

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Purpose: Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18–40 years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function.

Methods: Retrospective 8-year cohort study (February 2012–March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland.

Results: In the combined cohort, the forced expiratory volume in 1 s (FEV₁) was clinically abnormal for 54% of First Nations patients (51% of non-First Nations patients), forced vital capacity (FVC) for 46% (36%), FEV₁/FVC% for 30% (36%), and gas diffusing capacity (D_LCO) for 44% (37%). A respiratory diagnosis was assigned by a respiratory physician in 78% of First Nations (76% non-First Nations) patients. Smoking, household smoke exposure, underweight BMI, and respiratory disease were associated with reduced lung function. In the 40% of patients (709/1765) followed up, FEV₁ and FVC significantly improved (mean change: zFEV₁ = 0.15 [95% CI 0.10–0.20]; zFVC = 0.25 [0.20, 0.31]), and FEV₁/FVC% significantly reduced (mean = − 0.10 [95%CI − 0.07 to − 0.03]), with no significant change in D_LCO. Patients with COPD had lower FEV₁ improvement, whilst underweight and obese patients had lower FVC improvement.

Conclusion: Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.

Original language	English
Pages (from-to)	417–425
Number of pages	9
Journal	Lung
Volume	199
Early online date	Jul 2021
DOIs	https://doi.org/10.1007/s00408-021-00453-7
Publication status	Published - Aug 2021

Bibliographical note

Funding Information:
We acknowledge and thank the First Nations Health Workers, First Nations project officers, doctors, nurses, and clinical measurements scientists on the IROC program for their tireless efforts. AJC is supported by a National Health and Medical Research Council (NHMRC) Postgraduate Scholarship (APP2003334). JM is supported by a Queensland Children’s Hospital Foundation (CHF) Fellowship (RPC0772019). AC is supported by a (NHMRC) Senior Practitioner Fellowship (APP1154302) and CHF top-up (#50286).

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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Collaro, A. J., Chang, A. B., Marchant, J. M., Chatfield, M. D., Dent, A., Blake, T., Mawn, P., Fong, K., & McElrea, M. S. (2021). Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland. Lung, 199, 417–425. https://doi.org/10.1007/s00408-021-00453-7

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title = "Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland",

abstract = "Purpose: Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18–40 years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function. Methods: Retrospective 8-year cohort study (February 2012–March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland. Results: In the combined cohort, the forced expiratory volume in 1 s (FEV1) was clinically abnormal for 54% of First Nations patients (51% of non-First Nations patients), forced vital capacity (FVC) for 46% (36%), FEV1/FVC% for 30% (36%), and gas diffusing capacity (DLCO) for 44% (37%). A respiratory diagnosis was assigned by a respiratory physician in 78% of First Nations (76% non-First Nations) patients. Smoking, household smoke exposure, underweight BMI, and respiratory disease were associated with reduced lung function. In the 40% of patients (709/1765) followed up, FEV1 and FVC significantly improved (mean change: zFEV1 = 0.15 [95% CI 0.10–0.20]; zFVC = 0.25 [0.20, 0.31]), and FEV1/FVC% significantly reduced (mean = − 0.10 [95%CI − 0.07 to − 0.03]), with no significant change in DLCO. Patients with COPD had lower FEV1 improvement, whilst underweight and obese patients had lower FVC improvement. Conclusion: Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.",

author = "Collaro, {Andrew J.} and Chang, {Anne B.} and Marchant, {Julie M.} and Chatfield, {Mark D.} and Annette Dent and Tamara Blake and Patsi Mawn and Kwun Fong and McElrea, {Margaret S.}",

note = "Funding Information: We acknowledge and thank the First Nations Health Workers, First Nations project officers, doctors, nurses, and clinical measurements scientists on the IROC program for their tireless efforts. AJC is supported by a National Health and Medical Research Council (NHMRC) Postgraduate Scholarship (APP2003334). JM is supported by a Queensland Children{\textquoteright}s Hospital Foundation (CHF) Fellowship (RPC0772019). AC is supported by a (NHMRC) Senior Practitioner Fellowship (APP1154302) and CHF top-up (#50286). Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

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doi = "10.1007/s00408-021-00453-7",

language = "English",

volume = "199",

pages = "417–425",

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Collaro, AJ, Chang, AB, Marchant, JM, Chatfield, MD, Dent, A, Blake, T, Mawn, P, Fong, K & McElrea, MS 2021, 'Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland', Lung, vol. 199, pp. 417–425. https://doi.org/10.1007/s00408-021-00453-7

TY - JOUR

T1 - Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland

AU - Collaro, Andrew J.

AU - Chang, Anne B.

AU - Marchant, Julie M.

AU - Chatfield, Mark D.

AU - Dent, Annette

AU - Blake, Tamara

AU - Mawn, Patsi

AU - Fong, Kwun

AU - McElrea, Margaret S.

N1 - Funding Information: We acknowledge and thank the First Nations Health Workers, First Nations project officers, doctors, nurses, and clinical measurements scientists on the IROC program for their tireless efforts. AJC is supported by a National Health and Medical Research Council (NHMRC) Postgraduate Scholarship (APP2003334). JM is supported by a Queensland Children’s Hospital Foundation (CHF) Fellowship (RPC0772019). AC is supported by a (NHMRC) Senior Practitioner Fellowship (APP1154302) and CHF top-up (#50286). Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/8

Y1 - 2021/8

N2 - Purpose: Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18–40 years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function. Methods: Retrospective 8-year cohort study (February 2012–March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland. Results: In the combined cohort, the forced expiratory volume in 1 s (FEV1) was clinically abnormal for 54% of First Nations patients (51% of non-First Nations patients), forced vital capacity (FVC) for 46% (36%), FEV1/FVC% for 30% (36%), and gas diffusing capacity (DLCO) for 44% (37%). A respiratory diagnosis was assigned by a respiratory physician in 78% of First Nations (76% non-First Nations) patients. Smoking, household smoke exposure, underweight BMI, and respiratory disease were associated with reduced lung function. In the 40% of patients (709/1765) followed up, FEV1 and FVC significantly improved (mean change: zFEV1 = 0.15 [95% CI 0.10–0.20]; zFVC = 0.25 [0.20, 0.31]), and FEV1/FVC% significantly reduced (mean = − 0.10 [95%CI − 0.07 to − 0.03]), with no significant change in DLCO. Patients with COPD had lower FEV1 improvement, whilst underweight and obese patients had lower FVC improvement. Conclusion: Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.

AB - Purpose: Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18–40 years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function. Methods: Retrospective 8-year cohort study (February 2012–March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland. Results: In the combined cohort, the forced expiratory volume in 1 s (FEV1) was clinically abnormal for 54% of First Nations patients (51% of non-First Nations patients), forced vital capacity (FVC) for 46% (36%), FEV1/FVC% for 30% (36%), and gas diffusing capacity (DLCO) for 44% (37%). A respiratory diagnosis was assigned by a respiratory physician in 78% of First Nations (76% non-First Nations) patients. Smoking, household smoke exposure, underweight BMI, and respiratory disease were associated with reduced lung function. In the 40% of patients (709/1765) followed up, FEV1 and FVC significantly improved (mean change: zFEV1 = 0.15 [95% CI 0.10–0.20]; zFVC = 0.25 [0.20, 0.31]), and FEV1/FVC% significantly reduced (mean = − 0.10 [95%CI − 0.07 to − 0.03]), with no significant change in DLCO. Patients with COPD had lower FEV1 improvement, whilst underweight and obese patients had lower FVC improvement. Conclusion: Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.

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U2 - 10.1007/s00408-021-00453-7

DO - 10.1007/s00408-021-00453-7

M3 - Article

C2 - 34218310

AN - SCOPUS:85109300204

SN - 0341-2040

VL - 199

SP - 417

EP - 425

JO - Lung

JF - Lung

ER -

Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland

Abstract

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