哮喘联盟

   摘要
   背景：与其他种族相比，毛利人和太平洋地区儿童哮喘治疗疗效较差。
   目的：旨在通过年龄、性别、种族来评估新西兰儿童哮喘治疗的推荐方案和疗效。
   方法：从国家药业索赔数据库中纳入年龄＜15岁，哮喘药物使用次数＞2次的患者(N=80,514)，评估口服激素次数＞2次和主要因哮喘入院的患者，并对比哮喘治疗阶段和根据年龄和种族划分的住院患者。
   结果：16.0%的儿童使用过哮喘治疗药物，9.2%的儿童药物使用次数＞2次，3.6%的儿童因哮喘入院治疗至少一次且98.9%的住院患者是急性发作。毛利人(OR 1.46,95%CI, 1.41-1.51)和太平洋地区的儿童(OR 2.38,95%CI 2.28-2.47)更可能维持在最低治疗阶段。在各治疗阶段中，毛利人和太平洋地区的儿童口服激素的比率更高。在所有年龄组中，毛利人(5.1%,OR 1.88,95%CI 1.73-2.04)和太平洋地区儿童(5.6%,OR 2.05,95%CI 1.84-2.29)与其他种族的儿童(2.8%)相比，因哮喘住院的比率更高。
   结论：毛利人和太平洋地区的儿童与其他儿童相比，治疗阶段升级的可能性较小。他们更有可能使用口服激素去控制哮喘急性发作，重症哮喘急性发作才入院治疗。新西兰的数据可以用来监测这些结果。
 

（林江涛 审校）
PrimCareRespirJ.2013Aug12.pii:pcrj-2013-02-0017-R2. doi: 10.4104/pcrj.2013.00068. [Epub ahead of print]

 

Ethnic disparities in asthma treatment and outcomes in children aged under 15 years in New Zealand: analysis of national databases.
 

Gillies TD, Tomlin AM, Dovey SM, Tilyard MW.

Abstract
 

BACKGROUND: Mãori and Pacific children experience poorer outcomes relating to asthma management than other ethnicities.
AIMS: To measure recommended treatment and outcomes for asthma in all New Zealand children by age, sex, and ethnic group.
METHODS: Children aged <15 years dispensed >2 asthma medicines (N=80,514) were identified from the national pharmaceutical claims database. We measured the number of children dispensed oral steroids >2 times and hospital admissions with a primary diagnosis of asthma and compared asthma treatment steps and hospitalisation by age and ethnicity.
RESULTS: 16.0% of children were dispensed asthma medicines, 9.2% were dispensed medicine >2 times, 3.6% of children were hospitalised at least once for asthma and 98.9% of admissions were acute. Mãori (OR 1.46, 95% CI 1.41 to 1.51) and Pacific children (OR 2.38, 95% CI 2.28 to 2.47) were more likely to remain on the lowest step of treatment. At all steps of treatment, Mãori and Pacific children had higher rates of oral steroid use. In all age groups, more Mãori children (5.1%, OR 1.88, 95% CI 1.73 to 2.04) and Pacific children (5.6%, OR 2.05, 95% CI 1.84 to 2.29) were hospitalised for asthma than children of other ethnicities (2.8%).
CONCLUSIONS: Mãori and Pacific children are less likely to have their treatment escalated to a higher step than other children. They are also more likely to use oral steroids to control asthma exacerbations and be admitted to hospital for severe asthma episodes. New Zealand databases can be used to monitor these outcomes.
 

PrimCareRespirJ.2013Aug12.pii:pcrj-2013-02-0017-R2. doi: 10.4104/pcrj.2013.00068. [Epub ahead of print]