哮喘联盟

   摘要
   背景和目标：哮喘控制不佳。本研究旨在降低哮喘患者医疗保健需求和缺勤情况。
   材料和方法：多中心、随机、对照研究调查了哮喘患者的哮喘控制、教育参数、卫生服务使用和缺勤情况。根据GINA推荐调整治疗后，对照组（CG）遵循医生推荐，而干预组（IG）额外接受5分钟教育干预。本治疗方案为期3个月，并于第6个月实施最终评估。
   结果：初期治疗纳入479例患者（平均年龄40岁，SD17），334例患者完成研究。比较而言，IG组患者第3、6个月评估时的六个教育参数有所改善(P<0.001)，因哮喘发作而紧急拜访全科医生（GP）的次数更少[RR=0.49 (95% CI 0.26-0.90); P<0.04]，第三次评估前，紧急拜访全科医生（GP）的次数也较少[RR=0.25 (95% CI 0.12-0.52); P<0.001]。第三次评估前，IG组计划拜访GP的次数较少[RR=0.48 (95% CI 0.28-0.82); P<0.003]，社区医疗次数也更少[RR=0.40 (95% CI 0.18-0.87); P<0.05]，且进医院急诊次数减少[RR=0.13 (95% CI 0.04-0.42); P<0.001]。此外，在第三次评估前，IG组患者缺勤次数 [RR=0.22 (95% CI 0.05-0.98); P<0.03] 和无法在家办公次数[RR=0.31 (95% CI 0.12-0.82); P<0.02]较少。
   结论：两个简短教育干预可改善哮喘教育，降低医疗资源使用和患者缺勤情况。
 

（苏楠 审校）
MedClin(Barc).2013Aug6.pii:S0025-7753(13)00407-7.doi:10.1016/j.medcli.2013.01.051. [Epub ahead of print]


 

Two short interventions to reduce health care requirements in asthma patients. A multicentre controlled study (ASTHMACAP II).
 

Morell F, Ojanguren I, Cordovilla R, Urrutia I, Agüero R, Guerra J, Genover T, Ramon MA; the ASMACAP Study Group.
 

Abstract
BACKGROUND AND OBJECTIVE: Asthma control is suboptimal. The objective of this study was to reduce health care requirements and work absenteeism.
MATERIAL AND METHODS: Multicenter randomized controlled study investigating asthma control, educational parameters, health service use, and absenteeism. After adjusting treatment according to GINA recommendations, control group patients (CG) followed their physician's recommendations, while intervention group (IG) patients additionally underwent a 5-minute educational intervention. This protocol was repeated at 3 months, and a final assessment was carried out at 6 months.
RESULTS: 479 patients (mean age 40 (SD 17) years) were recruited from primary care, and 334 completed the study. Comparatively, IG patients showed an improvement at the 3- and 6-month evaluations in the six educational parameters (P<0.001) and required fewer urgent visits to the GP for exacerbations [RR=0.49 (95% CI 0.26-0.90); P<0.04], and before the third evaluation, also in urgent GP visits [RR=0.25 (95% CI 0.12-0.52); P<0.001]. Before this third evaluation, IG had fewer scheduled visits to the GP [RR=0.48 (95% CI 0.28-0.82); P<0.003], and fewer visits to the primary care [RR=0.40 (95% CI 0.18-0.87); P<0.05], and to hospital emergency rooms [RR=0.13 (95% CI 0.04-0.42); P<0.001]. In addition, before the third evaluation, IG patients were less often absent from work [RR=0.22 (95% CI 0.05-0.98); P<0.03] or unable to work at home [RR=0.31 (95% CI 0.12-0.82); P<0.02].
CONCLUSIONS: Two short educational interventions improved asthma education and decreased the use of health resources and work absenteeism.
 

MedClin(Barc).2013Aug6.pii:S0025-7753(13)00407-7.doi:10.1016/j.medcli.2013.01.051. [Epub ahead of print]