哮喘联盟

   摘要
   哮喘药物治疗的获益已被确定，但治疗的依从性差，这可能与哮喘急性发作的风险增加相关。本研究的目旨在回顾成人和儿童中哮喘控制药物治疗依从性与重度哮喘急性发作关联性的文献。从起初至2014年1月在PUBMED、 EMBASE、Web of Science上进行系统的文献检索，如果为药物依从性和重度哮喘急性发作关联性的数据则纳入的研究。使用Newcastle-Ottawa Scale修改版进行质量评估。检索出2319篇不同的文献，其中23篇符合纳入标准，并进行数据提取和质量评分。排除一篇正式的有关依从性和急性发作评估、设计和分析的高度异质性的交叉研究的Meta分析。尽管结果的测量相差很大，在高质量的研究中显示良好的依从性与较少的重度哮喘急性发作有关。良好的依从性与较低的重度哮喘急性发作风险相关。未来的研究应使用标准化的方法来评估依从性和急性发作，并且应当考虑到吸入能力。
 

（林江涛 审校）
Eur Respir J. 2014 Oct 16. pii: erj00756-2014. [Epub ahead of print]


 

Medication adherence and the risk of severe asthma exacerbations: a systematic review.
 

Engelkes M1, Janssens HM2, de Jongste JC2, Sturkenboom MC3, Verhamme KM3.
 

ABSTRACT
The benefits of drug therapy for asthma have been well established, but adherence to treatment is poor, and this might be associated with an increased risk of asthma exacerbations. The aim of this study was to review the literature on the association between adherence to asthma controller treatment and risk of severe asthma exacerbations in children and adults. A systematic literature search was performed in PubMed, Embase and Web of Science, from inception until January 2014. Studies were included if data on the association between medication adherence and severe asthma exacerbations were presented. Quality was assessed using a modified version of the Newcastle-Ottawa Scale. The search yielded 2319 unique publications, of which 23 met the inclusion criteria and underwent data extraction and quality scoring. High levels of heterogeneity across studies with regard to adherence and exacerbation measurements, designs and analysis precluded a formal meta-analysis. Although effect measures varied widely, good adherence was associated with fewer severe asthma exacerbations in high-quality studies. Good adherence tended to be associated with lower risk of severe asthma exacerbations. Future studies should use standardised methodology to assess adherence and exacerbations, and should consider inhaler competence.
 

Eur Respir J. 2014 Oct 16. pii: erj00756-2014. [Epub ahead of print]