哮喘患儿的用药:不只是儿童的体型大小
2011/11/23
摘要
目的:目前全球小儿哮喘的疾病负担仍然很重。由于小儿哮喘产生的直接健康护理开支,以及父母工作能力丧失、缺课和住院导致的间接开支日益增加,给政府和医疗卫生系统产生了严重影响。尽管人们已经研发出诸多有效药物,但小儿哮喘的药物治疗仍存在不足。本综述通过搜集经验性文献,研究小儿哮喘药物治疗中的相关问题。研究结果将有助于我们设计出更好的干预方法,从而改进小儿哮喘的药物治疗。
方法:采用网络搜索引擎,检索Medline、国际药学文摘(IPA)、PubMed、PsycINFO、护理和联合卫生文献累积索引(CINAHL)数据库。检索关键词为“哮喘”、“儿童”和“药物”(或这些关键词的简写)。
结果:检索关键词扩展到检索结果中出现的新兴主题。找出与父母、儿童、医护人员、组织机构、儿童专用药品和设备相关的内容主题。这些主题中的关键问题包括:父母缺乏哮喘及其药物治疗的相关知识、父母缺少信息来源、父母的信心和畏惧心理、父母的行为问题、药物治疗和设备的高开支、儿童自我定位、儿童责任感不足、医生治疗不符合哮喘指南、不按说明书用药、教师理解不善、缺少教育资源和儿童专用药品。
结论:上述关键问题是健康教育课程开发和改进过程中应当考虑的。这些课程应当将焦点对准患儿自身、父母/监护人、医护人员和各类组织机构。
(林江涛 审校)
J Asthma. 2011 Oct 21. [Epub ahead of print]
Medication Use in Children with Asthma: Not a Child Size Problem.
Grover C, Armour C, Asperen PP, Moles R, Saini B.
Source
Faculty of Pharmacy, University of Sydney, Camperdown Campus, Sydney , New South Wales , Australia .
Abstract
OBJECTIVE:The global burden of pediatric asthma is high. Governments and health-care systems are affected by the increasing costs of childhood asthma-in terms of direct health-care costs and indirect costs due to loss of parental productivity, missed school days, and hospitalizations. Despite the availability of effective treatment, the current use of medications in children with asthma is suboptimal. The purpose of this review is to scope the empirical literature to identify the problems associated with the use of pediatric asthma medications. The findings will help to design interventions aiming to improve the use of asthma medications among children. METHODS:A literature search using electronic search engines (i.e., Medline, International Pharmaceutical Abstracts (IPA), PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) and the search terms "asthma," "children," and "medicines" (and derivatives of these keywords) was conducted.
RESULTS:The search terms were expanded to include emergent themes arising out of search findings. Content themes relating to parents, children themselves, health-care professionals, organizational systems, and specific medications and devices were found. Within these themes, key issues included a lack of parental knowledge about asthma and asthma medications, lack of information provided to parents, parental beliefs and fears, parental behavioral problems, the high costs of medications and devices, the child’s self-image, the need for more child responsibility, physician nonadherence to prescribing guidelines, "off-label" prescribing, poor understanding of teachers, lack of access to educational resources, and specific medications.
CONCLUSION:These key issues should be taken into account when modifying the development of educational tools. These tools should focus on targeting the children themselves, the parent/carers, the health-care professionals, and various organizational systems.
J Asthma. 2011 Oct 21. [Epub ahead of print]
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第二代抗组胺药治疗过敏性鼻炎合并哮喘的疗效
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瑜伽是否有利于哮喘治疗?随机临床试验的系统综述