定期哮喘管理能改善哮喘控制
2012/04/06
背景:成功的哮喘控制需要以指南为基础的治疗和有规律的随访。本试验在由全科医生和专业护士治疗的哮喘患者中,基于全球哮喘防治创议(GINA)指南,采用系统哮喘咨询指导来评价哮喘控制水平。
方法:18~79岁的哮喘患者入选本研究。哮喘治疗时,医生被要求遵循GINA指南原则进行咨询指导。这包括对哮喘症状、治疗、依从性、肺功能和基于哮喘控制水平确定的定期随访进行评价。
结果:基础水平下,684名患者(36.8%)诊断为哮喘良好控制,740名(39.8%)诊断为哮喘部分控制,434名(23.4%)诊断为哮喘未得到控制。对1784名患者进行随访,623名(35%)患者接受随访。反应分析显示,参与随访者年龄较大(46岁和45岁;P<0.01),但其他指标两者相似。与基础水平相比,随访者的哮喘控制水平较高(哮喘未控制者:29.7%和16.5%;P<0.001)。随访显示随访者治的疗存在变化(P<0.01),而且随访者肺功能也得到改善。
结论:虽然大多数哮喘患者接受了哮喘治疗,仍有相当部分患者哮喘部分控制或控制很差。当医护人员给予系统哮喘管理措施后,总体哮喘控制得到改善。
(刘国梁 审校)
Respir Med. 2012 Feb 18. [Epub ahead of print]
Scheduled asthma management in general practice generally improve asthma control in those who attend.
Backer V, Bornemann M, Knudsen D, Ommen H.
Source
Dept of Respiratory Medicine L, Respiratory Research Unit, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Abstract
BACKGROUND: Successful asthma management involves guideline-based treatment and regular follow-up. We aimed to study the level of disease control in asthmatic individuals managed by their GP and a dedicated nurse when using a systematic asthma consultation guide based on Global Initiative of Asthma guidelines (GINA guidelines).
METHODS: Patients aged 18-79 years with doctor-diagnosed asthma were included. When managing the patients, the clinics were instructed to follow a consultation guide based on the principles of the GINA guidelines. This included evaluation of symptoms, treatment, compliance, lung function, and a scheduled follow-up appointment based on the level of asthma control.
RESULTS: At the initial visit (baseline), 684 patients (36.8%) were classified as well-controlled, 740 (39.8%) as partly controlled and 434 (23.4%) as uncontrolled. 1784 patients had been offered a follow-up visit and 623 (35%) had attended. A response analysis was performed, and those participating were older (46 versus 45 years, p < 0.01), whereas other variables were similar. A higher level of asthma control was found at the follow-up visit compared to the baseline visit (uncontrolled asthma 29.7% and 16.5%, respectively, p < 0.001). At the time of the follow-up visit, changes in treatment strategies were found (p < 0.01), and furthermore, level of lung function improved at the follow-up visit.
CONCLUSION: Although most asthmatic individuals received asthma treatment, a substantial number still were partly or poorly controlled. The overall asthma control improved significantly when a systematic asthma management approach was introduced and applied by dedicated health care staff.
Respir Med. 2012 Feb 18. [Epub ahead of print]
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采用圣乔治呼吸系统疾病问卷调查评估皮质激素吸入治疗的哮喘患者的健康相关性生活质量
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