老年哮喘患者的宣教：来自美国哮喘调查的结果
2011/03/24
摘要
基本原理：虽然哮喘教育对于年轻患者具有一定作用，但其在老年患者中的作用目前尚不清楚。
方法：采用来自美国4个州的国家哮喘调查（NAS）数据，比较已经通过宣教，学会使用峰值流量计（PFM）和哮喘行动计划（AAP）的老年患者（≥65岁）和对上述未有了解的老年患者间的哮喘控制。同时，比较接受过和未接受哮喘课程的老年患者间的哮喘控制。比较短期（过去1周的症状、过去30天的日间和夜间症状、过去3个月的激素使用）和长期（过去1年的哮喘发作、急诊就诊、住院及行动受限）的哮喘转归。
结果：398名老年哮喘患者入选本研究。接受PFM和AAP使用培训和未接受上述培训的老年哮喘患者间，短期和长期哮喘转归无显著差异。初步分析显示，接受哮喘课程的老年患者更可能出现至少1项控制较差的长期转归指标(81 vs. 65%, p = 0.034)。然而，logistic回归分析未见差异有显著性。
结论：接受哮喘宣教、对哮喘行动计划进行指导、学习使用PFM似乎并不影响老年哮喘患者的哮喘转归。为使老年哮喘患者获得更好的哮喘控制，需制定针对性的宣教措施。
（苏楠 审校）
J Asthma. 2010 Dec 6. [Epub ahead of print]
Asthma Education for Older Adults: Results from the National Asthma Survey.
Baptist AP, Talreja N, Clark NM.
Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Abstract
Rationale. Although asthma education is effective in younger population, it is unknown whether it is effective in older adults.
Methods. Using the Four-State National Asthma Survey (NAS) data, asthma control was compared between older adults (≥65 years) who had been taught to use a peak flow meter (PFM) and asthma action plan (AAP) with those who had not. We also compared older adults who had taken an asthma course with those who had not. Both short-term (symptoms within last 1 week, day and night symptoms in last 30 days, and the use of steroid in last 3 months) and long-term (asthma attack, emergency department visit, hospitalizations, and activity limitations in the prior year) outcomes were compared. Results. Three hundred and ninety-eight older adults with asthma were identified. There were no differences in the short- and long-term asthma outcomes between the older adults who had or had not received instruction on PFM or AAP use. In preliminary analysis, those who took AC were more likely to have at least one poorly controlled long-term outcome measure (81 vs. 65%, p = 0.034). However, this difference did not remain significant in a logistic regression analysis.
Conclusions. Engagement in asthma education course, instruction on action plans, and instruction on PFM use does not appear to affect asthma outcomes in older adults. Education specifically tailored toward older adults is required for better asthma control.
J Asthma. 2010 Dec 6. [Epub ahead of print]
基本原理：虽然哮喘教育对于年轻患者具有一定作用，但其在老年患者中的作用目前尚不清楚。
方法：采用来自美国4个州的国家哮喘调查（NAS）数据，比较已经通过宣教，学会使用峰值流量计（PFM）和哮喘行动计划（AAP）的老年患者（≥65岁）和对上述未有了解的老年患者间的哮喘控制。同时，比较接受过和未接受哮喘课程的老年患者间的哮喘控制。比较短期（过去1周的症状、过去30天的日间和夜间症状、过去3个月的激素使用）和长期（过去1年的哮喘发作、急诊就诊、住院及行动受限）的哮喘转归。
结果：398名老年哮喘患者入选本研究。接受PFM和AAP使用培训和未接受上述培训的老年哮喘患者间，短期和长期哮喘转归无显著差异。初步分析显示，接受哮喘课程的老年患者更可能出现至少1项控制较差的长期转归指标(81 vs. 65%, p = 0.034)。然而，logistic回归分析未见差异有显著性。
结论：接受哮喘宣教、对哮喘行动计划进行指导、学习使用PFM似乎并不影响老年哮喘患者的哮喘转归。为使老年哮喘患者获得更好的哮喘控制，需制定针对性的宣教措施。
（苏楠 审校）
J Asthma. 2010 Dec 6. [Epub ahead of print]
Asthma Education for Older Adults: Results from the National Asthma Survey.
Baptist AP, Talreja N, Clark NM.
Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Abstract
Rationale. Although asthma education is effective in younger population, it is unknown whether it is effective in older adults.
Methods. Using the Four-State National Asthma Survey (NAS) data, asthma control was compared between older adults (≥65 years) who had been taught to use a peak flow meter (PFM) and asthma action plan (AAP) with those who had not. We also compared older adults who had taken an asthma course with those who had not. Both short-term (symptoms within last 1 week, day and night symptoms in last 30 days, and the use of steroid in last 3 months) and long-term (asthma attack, emergency department visit, hospitalizations, and activity limitations in the prior year) outcomes were compared. Results. Three hundred and ninety-eight older adults with asthma were identified. There were no differences in the short- and long-term asthma outcomes between the older adults who had or had not received instruction on PFM or AAP use. In preliminary analysis, those who took AC were more likely to have at least one poorly controlled long-term outcome measure (81 vs. 65%, p = 0.034). However, this difference did not remain significant in a logistic regression analysis.
Conclusions. Engagement in asthma education course, instruction on action plans, and instruction on PFM use does not appear to affect asthma outcomes in older adults. Education specifically tailored toward older adults is required for better asthma control.
J Asthma. 2010 Dec 6. [Epub ahead of print]
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