哮喘联盟

   摘要
   目的：目前评估哮喘控制的工具不包括对可能直接影响控制的因素进行的评估部分。我们的目的在于评估评估患者依从性、吸入器使用技术和哮喘控制水平的关系。
   方法：对于3个月内阿曼，马斯喀特，苏丹卡布斯大学医院的哮喘患者，采用哮喘控制测试、个人吸入器使用技术清单和患者药物治疗方案新问卷测量控制情况、吸入器使用技术和依从性。
   结果：共218例患者接受了吸入类固醇治疗，联合长效β受体激动剂治疗(86.2%)或单药治疗。92例(42.2%)患者哮喘控制良好，其中分别包括38名(50%)男性和54名女性(38%)(P = 0.059)。40.8% (89)和18.3% (40)的患者依从性和吸入器使用技术较差。分别有60%(36)依从性好的患者、59.4% (41)部分依从的患者控制良好，83.1% (74)依从性差的患者控制不良。在92例控制良好的患者中，86 (93.5%)例患者吸入器使用技术良好。相反，85% (34)吸入器使用技术差的患者控制不良（比值比[OR]=5.3; 95%可信区间[CI]: 2.05-14.8; P <0.001）。共有93.3% (56)依从性好的患者、89.9% (62)部分依从的患者吸入器使用技术良好（P <0.001）。在控制良好的患者中，35 (38%)吸入器使用技术的依从性均很好，38 (41.3%)吸入器使用技术好但为部分依从性。
   结论：吸入器使用技术好和依从性好的患者哮喘控制较好。除非识别、评估并消除了导致控制不良的原因，不然哮喘控制情况仍会维持不佳。我们建议在目前评估工具中加入吸入器使用技术评估和患者对处方治疗的依从性测量。
 

（刘国梁 审校）
J Asthma. 2013 Dec 5. [Epub ahead of print]

Asthma control: Importance of compliance and inhaler technique assessments.

Baddar S, Jayakrishnan B, Al-Rawas OA.

ABSTRACT
OBJECTIVES: The available assessment tools to determine asthma control do not include components assessing factors that may directly affect control. Our aim was to evaluate the relationship between patient compliance, inhaler technique and the level of asthma control.
METHODS: Scores from the Asthma Control Test, individual inhaler device checklists and a novel questionnaire on the patient's medication regimen were used to measure control, inhaler technique and compliance, respectively, in patients with asthma attending Sultan Qaboos University Hospital, Muscat, Oman during a three month period.
RESULTS: All of the 218 patients were receiving inhaled steroids, either in combination with long-acting beta agonists (86.2%) or alone. Asthma control was good in 92 (42.2%) patients; with 38 males (50%) and 54 females (38%), respectively (P = 0.059). Compliance and inhaler technique were poor in 40.8% (89) and 18.3% (40) of the patients. Sixty percent (36) of the patients with good and 59.4% (41) with partial compliance had good control (P <0.001) while 83.1% (74) with poor compliance had poor control. Of the 92 patients with good control, 86 (93.5%) exhibited good inhaler techniques. In contrast, 85% (34) of the patients with poor inhaler techniques demonstrated poor control (odds ratio [OR] = 5.3; 95% confidence interval [CI]: 2.05-14.8; P <0.001). A total of 93.3% (56) with good and 89.9% (62) with partial compliance demonstrated good inhaler techniques (P <0.001). In patients with good control, 35 (38%) exhibited both good inhaler techniques and compliance and 38 (41.3%) had a good technique and partial compliance.
CONCLUSION: Patients with good inhaler techniques and compliance have better control of their asthma. Asthma control will remain suboptimal unless the reasons for this lack of control are identified, assessed and eliminated. We recommend that inhaler technique assessment and measurements of patient compliance with their prescribed treatments should be considered for inclusion in the current assessment tools.

J Asthma. 2013 Dec 5. [Epub ahead of print]