哮喘联盟

   摘要
   目的：药物治疗在哮喘护理中很重要，但如何衡量药物的使用情况是始终存在的方法学难题。本研究旨在探讨青少年的药物配发注册数据和父母报告使用数据是否一致。
   方法：本研究是一项横断面研究，共纳入来自瑞典的基于人群出生队列的3316例青少年（11～14岁）哮喘患者，对瑞典处方药注册部提供的药物配发数据和父母报告的药物使用数据进行比较。计算药物配发不同时间点的敏感性、特异性和阳性预测值（3, 6, 12, 18和24个月）。采用逻辑回归分析探讨与一致性相关的因素。
   结果：过去一年中父母报告的哮喘药物使用率为10.7% (n = 356)，注册信息显示药物配发率为8.1% (n = 269)(P ≤ 0.001)。敏感性随着距离药物配发时间延长而增加，而特异性在18个月时仍保持很高。虽然90%的青少年哮喘患者的父母报告他们已使用哮喘药物，但30%的患者在过去的18个月内并没有配发哮喘药物。在青少年严重哮喘患者中，药物配发数据和父母报告使用数据的一致性最高(OR 4.6, CI 1.2-17.6)。
   结论:当采用药物配发数据研究哮喘药物使用情况时，18个月是较适宜的时间段。但是，仍有很多青少年报告使用了哮喘药物，但实际在这期间却并没有购买任何哮喘药物。父母报告药物使用数据和药物配发数据的一致性在青少年严重哮喘患者中更高。
 

（刘国梁 审校） 
Pharmacoepidemiol Drug Saf. 2014 Jun 6. doi: 10.1002/pds.3662. [Epub ahead of print]

 

Factors associated with concordance between parental-reported use and dispensed asthma drugs in adolescents: findings from the BAMSE birth cohort.
 

Dahlén E1, Almqvist C, Bergström A, Wettermark B, Kull I.
 

ABSTRACT
PURPOSE: Pharmacological treatment is important in asthma care, but there are methodological challenges in measuring how drugs are used by patients. The aim of this study was to investigate the concordance between register data on dispensed drugs and parental-reported use of asthma drugs in adolescents.
METHODS: A cross-sectional study comparing data on dispensed drugs from the Swedish Prescribed Drug Register with data on parental-reported use of asthma drugs among 3 316 adolescents (age 11-14 years) in a population-based birth cohort in Sweden. Sensitivity, specificity, and positive predicted value for different time windows (3, 6, 12, 18, and 24 months) for dispensing in the register were computed. Logistic regression was used to explore factors associated with concordance.
RESULTS: The prevalence of parental-reported use of asthma drugs in the past year was 10.7% (n = 356) compared with 8.1% (n = 269) for dispensed drugs according to the register (p ≤ 0.001). The sensitivity increased with an extended time window in the register, whereas the specificity remained high up to 18 months. Although 90% of the adolescents with asthma had parental-reported use of asthma drugs, 30% of them had no such drugs dispensed in the preceding 18 months. The highest concordance was seen for adolescents with severe asthma (OR 4.6, CI 1.2-17.6).
CONCLUSIONS: An 18-month window is preferable when using dispensing data to study the use of asthma drugs. Still, many adolescents with reported drug use had not purchased any asthma drug in this period. The concordance between parental-reported use and dispensed drugs is higher for adolescents with severe asthma.
 

Pharmacoepidemiol Drug Saf. 2014 Jun 6. doi: 10.1002/pds.3662. [Epub ahead of print]