哮喘联盟

   摘要
   目的：长期管理被推荐用于哮喘患者，但很多患者并不依从随访治疗。患者不依从随访的原因和哮喘管理中止后的长期临床结局尚不清楚。本研究调查失访的相关因素和中止哮喘治疗的临床结局。
   方法：2005年1月至2007年3月，在韩国首尔的一所大学医院里，对近期确诊的成年哮喘患者的病例进行一项回顾性调查研究，比较基线人口特征和患者临床、实验室数据，确定他们在门诊是否成功的依从治疗至少3年。对失访3年的患者进行临床结局和哮喘控制状态的电话随访。
   结果：475例确诊的哮喘患者中共有351例（73.9%）失访达3年。失访的哮喘患者与随访超过3年的患者相比，诊断时年龄更小，哮喘严重程度的临床表现更轻（FEV1和PC20更高，治疗级别更低）（所有P<0.05）。198例对电话随访有反馈的患者中，有124例（62.6%）最终停止哮喘药物的治疗。124例停止治疗的哮喘患者与74例持续治疗的患者相比，维持症状改善的比率显著增加（77.4% vs. 55.4%，P=0.003）。
   结论：尽管医生推荐长期随访，但几乎四分之三的新确诊患者在3年内停止哮喘药物的治疗。大量的哮喘患者在没有药物治疗的情况下能维持长期的哮喘控制。
 

（苏楠 审校）
Allergy Asthma Immunol Res. 2013 Nov;5(6):357-64. doi: 10.4168/aair.2013.5.6.357.Epub 2013 Sep 27.

 

Lost to follow-up in asthmatics does not mean treatment failure: causes and
clinical outcomes of non-adherence to outpatient treatment in adult asthma.
 

Kang MG, Kim JY, Jung JW, Song WJ, Cho SH, Min KU, Kang HR.
 

Abstract
PURPOSE: Long-term asthma management is recommended to asthmatics; however, many patients do not adhere to follow-up treatment. It is unclear why many asthmatics do not adhere to follow-up treatment and long-term clinical course after discontinuation of asthma management. This study investigates the factors associated with loss to follow-up and observes the clinical course in asthmatics who discontinued asthma treatment.
METHODS: A retrospective investigation was conducted after reviewing medical records of adult patients who were newly diagnosed with asthma at a university hospital in Seoul, South Korea from January 2005 to March 2007. We compared baseline demographics and the clinical and laboratory profiles of patients to see if they successfully adhered to the treatment at an outpatient clinic for at least 3 years. The clinical course and asthma control status were surveyed by telephone for patients who were lost to follow-up within 3 years.
RESULTS: A total of 351 (73.9%) out of 475 patients were lost to follow-up within 3 years of asthma diagnosis. Patients lost to follow-up were younger and had clinical features of less severe asthma at time of diagnosis (higher FEV1 and PC20, and lower grade treatments) compared to patients who adhered to the follow-up for longer than 3 years (all P<0.05). Among the 198 responders to the telephone survey, 124 responders (62.6%) answered that they eventually discontinued asthma medication. A significantly higher proportion of the 124 responders who discontinued asthma treatment maintained symptom improvement compared to the 74 responders who continued asthma medication (77.4% vs. 55.4%, P=0.003).
CONCLUSIONS: Almost three quarters of newly diagnosed asthmatics discontinued asthma medication within 3 years despite a medical recommendation. There are considerable numbers of asthmatics who can maintain long-term asthma control status without medication.
 

Allergy Asthma Immunol Res. 2013 Nov;5(6):357-64. doi: 10.4168/aair.2013.5.6.357.
Epub 2013 Sep 27.