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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2020年03期

页码:

297-301

栏目:

论著

出版日期:

2020-06-20

文章信息/Info

Title:

Determinants of treatment compliance for inhaled glucocorticoids in asthma patients

作者:

娄月妍; 郑 宇; 张丽妍; 朱 枫; 吴学玲

201112 上海,上海交通大学医学院附属仁济南院呼吸科

Author(s):

Zhai Cui;  Song Yang;  Su Xiaofan;  Wang Qingting;  Shi Wenhua;  Li Manxiang.

Department of Respiratory and Critical Care Medicine, First Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an 710061, China

关键词:

支气管哮喘;  呼出气一氧化氮;  肺功能;  哮喘控制检测评分;  临床意义

Keywords:

Bronchial asthma;  Glucocorticoids;  Treatment compliance

分类号:

R562

DOI:

10.3877/cma.j.issn.1674-6902.2020.03.002

摘要:

目的 探讨支气管哮喘患者吸入性糖皮质激素治疗依从性不佳时关键的因素,明确患者自身对于治疗依从性的理解。方法 选择西安交通大学第一附属医院呼吸与危重症医学科2017年4月至2018年1月期间门诊年龄>18岁的哮喘患者350例,对选取的患者采用结构化面谈和横断面调查,进行相应的统计分析。结果 Logistic回归结果显示,使用糖皮质激素治疗有效,认为病情已控制或痊愈[OR=0.28,95%CI(0.16,0.48),P<0.01],哮喘症状加重或急性发作时才用药[OR=0.26,95%CI(0.15,0.46),P<0.01],费用较高难以承受经济负担[OR=0.36,95%CI(0.17,0.75),P<0.01],使用ICS出现不良反应而停用[OR=0.26,95%CI(0.08,0.81),P=0.02],担心药物不良反应[OR=1.59,95%CI(0.49,0.95),P=0.04]对哮喘患者吸入糖皮质激素治疗依从性的影响有显著性差异。结论 门诊成人哮喘患者吸入糖皮质激素治疗的依从性不佳与多种因素相关,需采用多种形式的患者教育,提高患者及其家属对哮喘本质及其规范治疗的认识,进而改善患者的哮喘控制水平和临床结局。

Abstract:

Objective To investigate the determinants of treatment compliance for inhaled glucocorticoids(ICS)in the asthma patients. Methods A total of 350 asthma outpatients older than 18 years of age who visited our hospital from 2017 July to 2018 February were selected for this study. Through structured interviews and cross-sectional investigations, the information and relevant data of their inhalation treatment compliance state and responses to determinants were collected to fill out the paper questionnaire, and then inputted into the on-line EQDC system by site investigator(s). And the valid data were taken into statistical analyses. Results Logistic regression results showed that the five factors were significantly different in the asthma patients with ICS treatment compliance, as follows, ①some asthma patients with ICS treatment thought that it was effective if the condition was controlled or cured [OR=0.28, 95%CI(0.16, 0.48), P<0.01], ② the symptoms of asthma patients were worsened or acutely exacerbated [OR=0.26, 95%CI(0.15, 0.46), P<0.01], ③ some asthma patients had difficulty in burdening the high cost [OR=0.36, 95%CI(0.17, 0.75), P<0.01], ④ ICS was discontinued due to adverse reactions [OR=0.26, 95%CI(0.08, 0.81), P=0.02], and ⑤ several asthma patients worried about the adverse drug reactions [OR=1.59, 95%CI(0.49, 0.95), P=0.04]. Conclusion Inadequate compliance with ICS in the outpatients with adult asthma is associated with various factors. Multiple forms of patient education are needed to improve the patients'and their family members'awareness of the nature of asthma and its standardized treatment, thereby improving the compliance and clinical outcomes of asthma.

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备注/Memo

备注/Memo:

基金项目: 国家自然科学基金资助项目(81270130)

常用功能

更新日期/Last Update: 2020-06-20