哮喘联盟

   摘要
   本研究旨在分析因短效吸入性β受体激动剂或吸入性类固醇激素耗尽而导致的哮喘患者急诊率，以及该类患者的群体特征。我们对1996－1998年间4个来自急诊的急性哮喘多中心研究数据进行二次分析（共64个急诊机构）。对每一项研究中的所有成年急性哮喘患者（18-54岁）均进行了结构式访谈，评估是否存在吸入性药物耗尽的情况。本研究共纳入1095例患者。总体来说，324例患者（30%；95%可信区间[CI]，27－32%）在急诊前一周用完了吸入性β受体激动剂或吸入性类固醇激素，其中311例患者（28%; 95% CI, 26-31%）用完的是吸入性β受体激动剂。在518例只用吸入性类固醇激素的亚组人群中，55例（11%; 95% CI, 8-14%）存在药物耗尽情况。在多变量模型中，哮喘药物耗尽的预测因素包括男性、非西班牙裔黑人种族、西班牙裔、无医疗保险、家庭收入低、以及首选急诊进行哮喘治疗等（P值均小于0.05）。在哮喘药物耗尽的患者中，急性哮喘发作前吸入性β受体激动剂用完的比例为49% (95% CI, 43-55%)，吸入性类固醇激素用完的比例为72% (95% CI, 58-84%)。在1095例急性哮喘的成年急诊患者中，我们发现急诊入院前发生吸入性哮喘药物耗尽的比例占30%。这些患者具有一些社会人口统计学特征，可能有助于识别可预防的急诊病例。我们应该采取多种措施保证吸入性药物的合理使用。
 

（苏楠 审校）
Allergy Asthma Proc. 2014 May;35(3):42-50. doi: 10.2500/aap.2014.35.3747.

 

Emergency department visits for acute asthma by adults who ran out of their inhaled medications.
 

Hasegawa K1, Brenner BE, Clark S, Camargo CA.
 

Abstract
This study was designed to determine the percentage of asthma-related emergency department (ED) visits made by patients who recently ran out of their inhaled short-acting beta-agonists or inhaled corticosteroids and to characterize this understudied patient population. A secondary analysis was performed of data from four ED-based multicenter studies of acute asthma during 1996-1998 (n = 64 EDs). In each study, consecutive adult patients, aged 18-54 years, with acute asthma underwent a structured interview that assessed running out of inhaled medications. The analytic cohort comprised 1095 adults. Overall, 324 patients (30%; 95% confidence interval [CI], 27-32%) ran out of either of their inhaled beta-agonists or inhaled corticosteroids during the week before their index ED visit; 311 (28%; 95% CI, 26-31%) ran out of inhaled beta-agonists per se. Among a subset of 518 patients on inhaled corticosteroids, 55 patients (11%; 95% CI, 8-14%) ran out of inhaled corticosteroids. In the multivariable model, predictors of running out of an asthma medication were male sex, non-Hispanic black race, Hispanic ethnicity, no insurance, lower household income, and use of EDs as the preferred source of asthma prescriptions (all p < 0.05). Among patients who ran out of medications, 49% (95% CI, 43-55%) ran out of inhaled beta-agonists and 72% (95% CI, 58-84%) ran out of inhaled corticosteroids, before onset of their acute asthma symptoms. In 1095 adult ED patients with acute asthma, we found that 30% ran out of their inhaled asthma medications before the ED visit. Asthma patients who ran out of medications had sociodemographic characteristics that may help with identification of preventable ED visits. Multifaceted strategies needed to ensure optimal use of inhaled medications are warranted.
 

Allergy Asthma Proc. 2014 May;35(3):42-50. doi: 10.2500/aap.2014.35.3747.