哮喘控制不佳与卫生资源利用增加和生活质量下降相关
2011/05/12
摘要
背景：哮喘控制与哮喘转归的关系目前尚未完全清楚。
目的：本试验旨在研究哮喘控制与健康相关生活质量(HRQL)及其卫生资源利用之间的关系。方法：本试验为期1年，是一项前瞻性纵向在线调查，共计497名成人哮喘患者和170名儿童患者入选。采用哮喘控制测试（ACT）和儿童ACT（C-ACT）对哮喘控制进行评估，根据评分，将哮喘控制分为：控制很好（>19）和控制不佳（≤19）。采用PedsQL™ 3.0哮喘模块（儿童）和SF-12健康调查（成人）检测HRQL。采用多变量模型进行分析。
结果：哮喘控制不佳的成人和儿童患者，其HRQL评分显著低于哮喘控制很好的哮喘患者 （平均分别低3.4和12.8）。在基线状态下，哮喘控制不佳的成人患者，随后9个月内，其哮喘相关的就诊风险增加3倍，哮喘相关的急诊就诊增加10倍（分别为OR=3.3和11.3）。哮喘控制不佳的儿童患者，哮喘相关的就诊和急诊就诊增加近5倍（分别为OR=4.8和4.9）。
结论：与ACT评分较高的哮喘患者相比，哮喘控制不佳的成人和儿童患者，其生活质量较低，更易出现哮喘相关的就诊和急诊就诊。因此，需持续对哮喘控制进行评价，相应的调整哮喘治疗方案。
（苏楠 审校 ）
J Asthma. 2011 Mar;48(2):126-32. Epub 2010 Dec 6.
Asthma that is not well-controlled is associated with increased healthcare utilization and decreased quality of life.
Guilbert TW, Garris C, Jhingran P, Bonafede M, Tomaszewski KJ, Bonus T, Hahn RM, Schatz M.
The Department of Pediatrics, University of Wisconsin, Madison, WI, USA.
Abstract
Background. Relationships of asthma control to other asthma outcomes have been incompletely documented.
Objective. This study examined the relationship between asthma control and health-related quality of life (HRQL) and subsequent healthcare resource utilization.
Methods. A 1-year online prospective longitudinal survey was conducted in 497 adults and 170 children with asthma treated in the past year. Control was measured by Asthma Control Test™ (ACT) and Childhood ACT™ (C-ACT)™ scores dichotomized into "well-controlled" (scores >19) or "not well-controlled" (scores ≤19), and HRQL was measured using the PedsQL™ 3.0 Asthma Module (children) and the SF-12 Health Survey (adults). Multivariate models were used for analysis.
Results. HRQL scores were significantly lower for adults (mean decrease 3.4) and children (mean decrease 12.8) whose asthma was not well-controlled compared to patients with well-controlled asthma. Adults with asthma that was not well-controlled at baseline had a threefold greater risk of an asthma-related doctor visit and a 10-fold greater risk of an emergency department (ED) visit for asthma in the subsequent 9 months (odds ratio (OR) = 3.3 and OR = 11.3, respectively). Children with asthma that was not well-controlled had a nearly fivefold increased risk for subsequent asthma-related doctors’ and ED visits (OR = 4.8 and OR = 4.9, respectively).
Conclusion. Both adults and children with not well-controlled asthma had significantly lower quality of life and were more likely to require an office or ED visit for asthma compared to patients with higher ACT scores. Therefore, it is important to continually assess asthma control and adjust controller therapy accordingly.
J Asthma. 2011 Mar;48(2):126-32. Epub 2010 Dec 6.
背景：哮喘控制与哮喘转归的关系目前尚未完全清楚。
目的：本试验旨在研究哮喘控制与健康相关生活质量(HRQL)及其卫生资源利用之间的关系。方法：本试验为期1年，是一项前瞻性纵向在线调查，共计497名成人哮喘患者和170名儿童患者入选。采用哮喘控制测试（ACT）和儿童ACT（C-ACT）对哮喘控制进行评估，根据评分，将哮喘控制分为：控制很好（>19）和控制不佳（≤19）。采用PedsQL™ 3.0哮喘模块（儿童）和SF-12健康调查（成人）检测HRQL。采用多变量模型进行分析。
结果：哮喘控制不佳的成人和儿童患者，其HRQL评分显著低于哮喘控制很好的哮喘患者 （平均分别低3.4和12.8）。在基线状态下，哮喘控制不佳的成人患者，随后9个月内，其哮喘相关的就诊风险增加3倍，哮喘相关的急诊就诊增加10倍（分别为OR=3.3和11.3）。哮喘控制不佳的儿童患者，哮喘相关的就诊和急诊就诊增加近5倍（分别为OR=4.8和4.9）。
结论：与ACT评分较高的哮喘患者相比，哮喘控制不佳的成人和儿童患者，其生活质量较低，更易出现哮喘相关的就诊和急诊就诊。因此，需持续对哮喘控制进行评价，相应的调整哮喘治疗方案。
（苏楠 审校 ）
J Asthma. 2011 Mar;48(2):126-32. Epub 2010 Dec 6.
Asthma that is not well-controlled is associated with increased healthcare utilization and decreased quality of life.
Guilbert TW, Garris C, Jhingran P, Bonafede M, Tomaszewski KJ, Bonus T, Hahn RM, Schatz M.
The Department of Pediatrics, University of Wisconsin, Madison, WI, USA.
Abstract
Background. Relationships of asthma control to other asthma outcomes have been incompletely documented.
Objective. This study examined the relationship between asthma control and health-related quality of life (HRQL) and subsequent healthcare resource utilization.
Methods. A 1-year online prospective longitudinal survey was conducted in 497 adults and 170 children with asthma treated in the past year. Control was measured by Asthma Control Test™ (ACT) and Childhood ACT™ (C-ACT)™ scores dichotomized into "well-controlled" (scores >19) or "not well-controlled" (scores ≤19), and HRQL was measured using the PedsQL™ 3.0 Asthma Module (children) and the SF-12 Health Survey (adults). Multivariate models were used for analysis.
Results. HRQL scores were significantly lower for adults (mean decrease 3.4) and children (mean decrease 12.8) whose asthma was not well-controlled compared to patients with well-controlled asthma. Adults with asthma that was not well-controlled at baseline had a threefold greater risk of an asthma-related doctor visit and a 10-fold greater risk of an emergency department (ED) visit for asthma in the subsequent 9 months (odds ratio (OR) = 3.3 and OR = 11.3, respectively). Children with asthma that was not well-controlled had a nearly fivefold increased risk for subsequent asthma-related doctors’ and ED visits (OR = 4.8 and OR = 4.9, respectively).
Conclusion. Both adults and children with not well-controlled asthma had significantly lower quality of life and were more likely to require an office or ED visit for asthma compared to patients with higher ACT scores. Therefore, it is important to continually assess asthma control and adjust controller therapy accordingly.
J Asthma. 2011 Mar;48(2):126-32. Epub 2010 Dec 6.
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