Page 26 - Delaware Medical Journal - May/June 2019

Comparison of Amish and Non-Amish Patients in a Single Pediatric Cystic Fibrosis Center:
A Retrospective, Case-Controlled Study
Rajeswary Padman Padmalingam, MD, FAAP, FCCP; Denise Gilham; Tina Laturner, RN; Alyaa Hussien, PharmD; Ron Jones; Gordon Bokhart, PharmD; Chelsea Hamilton, PharmD; Abeer Omar, PharmD
There exist evident differences in the
health of Amish people and in the
care they receive, in comparison to the general population. Amish patients
were 100% homozygous for delta F508 mutation, compared to 12% in the non- Amish population (P=0.057). The Amish community was prescribed dietary supplements at a rate of 89%, compared
to 50% for non-Amish (P=0.087). Body Mass Index (BMI) > 75th percentile was 51.25% in Amish patients and 61.25% in non-Amish patients (P=0.31). Mean forced expiratory volume in one second (FEV1) value was 83.6% versus 100%, while mean forced expiratory flow (FEF 25-75) value was 58% versus 86% for Amish and non-Amish people respectively. There was substantial variance in the number of episodes of
the same infection per patient between Amish and non-Amish population (1 IQR 0–1 versus 0 IQR 0–1; p=0.012). The rate
of antibiotic prescribing per patient in the Amish group was 7.9 prescriptions versus 2.2 prescriptions. The study aims to create the best possible treatment and the highest quality of life for patients with cystic fibrosis. Our manuscript creates a paradigm for future studies on the delta F508 mutation, nutrition supplements, BMI, FEV1, FEF 25-75, airway microbial organisms, and changes in antibiotic treatments in Amish compared to the non-Amish group, as well as for developing a platform for an Amish community health program.
KEYWORDS: delta mutation outcomes, nutritional status, lung function, antibiotic therapeutic, Amish, non-Amish pediatric, cystic fibrosis
Figure 1 BMI percentile in Amish and non-Amish populations
Figure 2 FEV1 Level (%) in Amish and non-Amish populations
122 Del Med J | May/June 2019 | Vol. 91
| No. 3
Abstract