哮喘患儿依指南推荐用药与父母获得的信息和知识有关：PIAMA队列研究
2014/04/15
摘要
目的：我们研究儿童哮喘用药和依指南推荐用药与可变的危险因素（如父母态度，对哮喘药物的认识程度和卫生保健者提供的信息）之间的关系。
方法：调查问卷数据来自过去12个月使用哮喘药物且参与哮喘和尘螨过敏发病率与预防的出生队列研究的8岁儿童的父母（229对）。他们报告了孩子的药物使用情况、自己对药物的认识程度和态度，以及从卫生保健者中获得的信息。
结果：非正规使用吸入糖皮质激素（ICS）普遍存在：当孩子无法呼吸时仅40%的父母给孩子使用ICS，52%仅在“孩子需要时”给予使用；有15%的父母尝试避免药物使用，25%的父母有时停止给药。父母对如何使用哮喘药物的认知程度是指南推荐用药的决定因素：知道抗炎药应每日使用的父母（占53%），有84%每天给孩子用药，而不知道的父母中这一比例仅为25%。指南推荐用药也与父母从卫生保健者中获取的信息显著相关。这种相关性不依赖于父母受教育的程度。
结论：我们的结果提示，实质性改善哮喘用药是可行的，这可能在一定程度上会改善目前哮喘的治疗疗效。
（苏楠 审校）
Pharmacoepidemiol Drug Saf. 2014 Feb 12. doi: 10.1002/pds.3584. [Epub ahead of print]
Guideline-recommended use of asthma medication by children is associated with parental information and knowledge: the PIAMA birth cohort.
Wijga AH, Zuidgeest MG, Kerkhof M, Koppelman GH, Smit HA, de Jongste JC.
Abstract
PURPOSE: We investigated the use of asthma medication by children and the association of use as recommended by guidelines with modifiable risk factors: parental attitudes, knowledge of asthma medication and information provided by health care providers.
METHODS: Questionnaire data were obtained from parents of 229 8-year-old children participating in the prevention and incidence of asthma and mite allergy birth cohort who used asthma medication in the past 12 months. They reported on their child's medication use, their own knowledge and attitudes towards the medication and their satisfaction with the information they received from health care providers.
RESULTS: Irregular use of inhaled corticosteroids (ICS) was common: 40% of the parents only gave their child ICS when the child felt breathless and 52% only 'when the child needed it'; 15% of the parents tried to avoid giving medication, and about 25% of the parents sometimes discontinued medication. Parental knowledge of how asthma medication should be given was a major determinant of guideline-recommended use: Of the parents who knew that anti-inflammatory drugs should be taken everyday (53% of all parents), 84% reported that they actually gave their child the medicines everyday as compared with 25% of the parents who did not know this. Guideline-recommended use was also significantly associated with parental satisfaction with the amount of information received from health care providers. These associations were independent of maternal school education.
CONCLUSIONS: Our findings suggest that substantial improvements in the use of asthma medication are feasible, and this could considerably improve the effectiveness of current asthma treatment.
Pharmacoepidemiol Drug Saf. 2014 Feb 12. doi: 10.1002/pds.3584. [Epub ahead of print]
