哮喘联盟

摘要
   目的：研究父母-儿童团队干预是否能改善哮喘儿童的用药依从性和哮喘相关转归。
   方法：本研究为随机临床试验，48名年龄9-15岁的受试者分为3组：团队干预组（TI组）、哮喘宣教组（AE组）和标准治疗组（SC）。治疗持续2个月，在随后3个月的随访期内对受试者进行评价。采用MDILog-II评价皮质激素吸入治疗的依从性。收集治疗前、治疗后及随访期内父母-儿童冲突、哮喘功能严重程度和肺活量评价结果。采用混合线性模型分析评价组和时间对哮喘转归的影响。
   结果：与AE组合SC组相比，TI组依从性较高，功能严重程度评分较低；与SC组相比，父母主诉的冲突较少和肺活量有增加的趋势。
   结论：结果显示，TI有助于改善儿童哮喘患者的治疗依从性，因为儿童获得更多的哮喘管理责任感。

（苏楠 审校）
J Pediatr Psychol. 2012 Dec 17. [Epub ahead of print]

Efficacy of a Parent-Youth Teamwork Intervention to Promote Adherence in Pediatric Asthma.

Duncan CL, Hogan MB, Tien KJ, Graves MM, Chorney JM, Zettler MD, Koven L, Wilson NW, Dinakar C, Portnoy J.

Source
Department of Psychology, West Virginia University, Department of Pediatrics, Health Sciences Center, West Virginia University, Clinical Child Psychology Program, University of Kansas, and Department of Pediatrics, Children's Mercy Hospitals and Clinics.

Abstract
OBJECTIVE: To determine whether a parent-youth teamwork intervention improved medication adherence and related outcomes among youth with asthma.
METHODS: We used a randomized clinical trial with 48 youth (aged 9-15 years) assigned to 1 of 3 groups: Teamwork Intervention (TI), Asthma Education (AE), or Standard Care (SC). Treatment occurred across 2 months, with a 3-month follow-up assessment. Adherence to inhaled corticosteroids was assessed via the MDILog-II. Parent-adolescent conflict, asthma functional severity, and spirometry assessments were obtained pre-treatment, post-treatment, and on follow-up. Mixed linear model analysis was used to evaluate group and time effects for outcome measures.
RESULTS: TI group had significantly higher adherence and lower functional severity scores than AE or SC conditions, and lower parent-reported conflict and a trend for higher spirometry values compared with the SC group.
CONCLUSIONS: Results suggest support for the efficacy of TI for improving medication adherence as youth acquire more responsibility for their asthma management.

J Pediatr Psychol. 2012 Dec 17. [Epub ahead of print]