对儿童哮喘患者进行长期教育的临床效果:Aironet 1年随机对照试验
2009/08/11
作为国际哮喘治疗指南所规定的一部分,对儿童哮喘患者进行自我管理的教育培训计划已经成为哮喘治疗的常规方法。本实验旨在研究针对儿童哮喘患者的Aironet(R)计划对儿童哮喘严重程度以及在改善患者对疾病认识上的作用。
123名患有间歇性或轻度持续性哮喘的儿童(72名男童)入选本项多中心、前瞻性随机对照试验,参与者平均年龄为8.78岁。入选患者随机分为受教育组和对照组。受教育组(n=60)的患者在研究开始时及2个月后分别接受Aironet(R)培训,对照组(n=63)不接受培训。随访12个月,随访内容包括门诊就诊及在第2、4、12个月进行肺活量检测。研究开始及12个月后,对患者的父母亲进行问卷调查,内容包括相关的哮喘知识、儿童哮喘发作情况、糖皮质激素全身使用情况、家庭医生或急诊就诊情况、住院以及与哮喘相关的缺课情况。
随访第12个月时的问卷调查结果显示,接受教育的患儿哮喘发作显著少于未接受教育的患儿(1.65±1.21 vs. 2.34±1.73; P< 0.05)。对于基线哮喘发作次数≥3次的患儿,受教育组患儿父母对哮喘相关知识的了解明显优于对照组。
门诊教育项目Aironet(R)能减少间歇性或轻度持续哮喘患儿的哮喘发作次数,改善父母对哮喘的认知。
(苏楠 审校)
Indinnimeo L, et al. Pediatr Allergy Immunol. 2009 Jun 12. [Epub ahead of print]
Clinical effects of a Long-term Educational Program for Children with Asthma - Aironet. A 1-yr randomized controlled trial.
Indinnimeo L, Bonci E, Capra L, La Grutta S, Monaco F, Paravati F, Passalacqua G, Silvestre G, Duse M.
Dipartimento di Pediatria, "Sapienza", Università di Roma, Italy.
Educational self-management programs for children with asthma have now become a routine feature in the management of the disease, as international guidelines underline. We designed this trial to find out whether Aironet((R)), an educational program developed for children with asthma, influenced asthma severity and improved parents’ knowledge of the disease. In a multicenter, prospective, randomized controlled trial we enrolled 123 children, 72 boys, mean age 8.78 yr (+/-2.33 s.d.), with intermittent or mild persistent asthma. Participants were randomly assigned to an education group, who received Aironet((R)) at baseline and 2 months later (60 children), or to a control group who did not (63 children). Follow-up lasted 12 months and included out-patient clinic visits and spirometry at 2, 4 and 12 months. At baseline and at 12 months follow-up, parents were questioned about their knowledge of asthma, and their children’s asthmatic attacks, use of systemic corticosteroids, family physician or hospital emergency room visits, hospitalizations and asthma-related school absences. Questionnaire replies at 12-month follow-up reported significantly fewer asthma attacks in patients who received the program than in those who did not (1.65 +/- 1.21 vs. 2.34 +/- 1.73; p < 0.05). For the subgroup of children who had >/=3 asthma attacks at baseline, parents’ knowledge improved significantly more in the educational group than in the control group. The out-patient educational program Aironet((R)) reduces the number of asthma attacks in children with intermittent or mild persistent asthma and improves knowledge of the disease.
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哮喘控制与医疗资源使用、工作能力丧失和健康相关生活质量的关系
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影响儿童哮喘用药的因素:来自澳大利亚哮喘教育专家的观点