摘要
目的探讨支气管哮喘患者吸入性糖皮质激素治疗依从性不佳时关键的因素,明确患者自身对于治疗依从性的理解。方法选择西安交通大学第一附属医院呼吸与危重症医学科2017年4月至2018年1月期间门诊年龄>18岁的哮喘患者350例,对选取的患者采用结构化面谈和横断面调查,进行相应的统计分析。结果Logistic回归结果显示,使用糖皮质激素治疗有效,认为病情已控制或痊愈[OR=0.28,95%CI(0.16,0.48),P<0.01],哮喘症状加重或急性发作时才用药[OR=0.26,95%CI(0.15,0.46),P<0.01],费用较高难以承受经济负担[OR=0.36,95%CI(0.17,0.75),P<0.01],使用ICS出现不良反应而停用[OR=0.26,95%CI(0.08,0.81),P=0.02],担心药物不良反应[OR=1.59,95%CI(0.49,0.95),P=0.04]对哮喘患者吸入糖皮质激素治疗依从性的影响有显著性差异。结论门诊成人哮喘患者吸入糖皮质激素治疗的依从性不佳与多种因素相关,需采用多种形式的患者教育,提高患者及其家属对哮喘本质及其规范治疗的认识,进而改善患者的哮喘控制水平和临床结局。
Objective To investigate the determinants of treatment compliance for inhaled glucocorticoids(ICS)in the asthma patients.Methods A total of 350 asthma outpatients older than 18 years of age who visited our hospital from 2017 July to 2018 February were selected for this study.Through structured interviews and cross-sectional investigations,the information and relevant data of their inhalation treatment compliance state and responses to determinants were collected to fill out the paper questionnaire,and then inputted into the on-line EQDC system by site investigator(s).And the valid data were taken into statistical analyses.Results Logistic regression results showed that the five factors were significantly different in the asthma patients with ICS treatment compliance,as follows,①some asthma patients with ICS treatment thought that it was effective if the condition was controlled or cured[OR=0.28,95%CI(0.16,0.48),P<0.01],②the symptoms of asthma patients were worsened or acutely exacerbated[OR=0.26,95%CI(0.15,0.46),P<0.01],③some asthma patients had difficulty in burdening the high cost[OR=0.36,95%CI(0.17,0.75),P<0.01],④ICS was discontinued due to adverse reactions[OR=0.26,95%CI(0.08,0.81),P=0.02],and⑤several asthma patients worried about the adverse drug reactions[OR=1.59,95%CI(0.49,0.95),P=0.04].Conclusion Inadequate compliance with ICS in the outpatients with adult asthma is associated with various factors.Multiple forms of patient education are needed to improve the patients′and their family members′awareness of the nature of asthma and its standardized treatment,thereby improving the compliance and clinical outcomes of asthma.
作者
翟翠
宋旸
苏小凡
王青婷
史文花
李满祥
Zhai Cui;Song Yang;Su Xiaofan;Wang Qingting;Shi Wenhua;Li Manxiang(Department of Respiratory and Critical Care Medicine, First Affiliated Hospital, College of Medicine, Xi′an Jiaotong University, Xi′an 710061, China)
出处
《中华肺部疾病杂志（电子版）》
CAS
2020年第3期302-306,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家自然科学基金资助项目(81330002,81670051)。
关键词
支气管哮喘
糖皮质激素
治疗依从性
Bronchial asthma
Glucocorticoids
Treatment compliance
