Adherence rate to inhaled corticosteroids and their impact on asthma control
Adherence rate to inhaled corticosteroids and their impact on asthma control
复制标题
DOI：
10.1111/j.1398-9995.2008.01877.x
复制
发表时间：
2009-05-01
期刊：
影响因子：
12.4
通讯作者：
Moura, J. A. R.
中科院分区：
文献类型：
--
作者：
Lasmar, L.;Camargos, P.;Moura, J. A. R.
哮喘控制不良与高发病率有关。为探讨丙酸倍氯米松（BDP）治疗依从性与哮喘控制程度之间的关系，随机选择122例3-12岁哮喘患者，在儿科肺科门诊进行为期12个月的同期队列研究。通过药房记录验证依从率。通过包括四个变量（夜间和早晨症状、体力活动受限和急性加重）的评分系统评估临床控制。总分为16分。评分低于或等于2的患者被认为是控制的（第1组），评分高于或等于3的患者被认为是未控制的（第2组）。对于能够进行肺功能测定的患者，我们将1 s内用力呼气容积（FEV 1）等于或大于预测值的80%的患者视为控制的患者，将FEV 1低于80%的患者视为未控制的患者，在122例患者中，不到一半（最大40.3%）的患者维持哮喘控制。第1组和第2组的中位依从率分别为85.5%和33.8%，术后4个月分别为90.0%和48.0%（P < 0.001）12个月时分别为84.4%和47.0在所有阶段，维持或不维持哮喘控制的依从率差异均有统计学意义。最佳哮喘控制需要依从率高于80%。降低哮喘发病率的策略应包括定期监测吸入类固醇的依从性。
Poor asthma control is associated to high morbidity. The objective of this study was to assess the association between adherence rates to beclomethasone dipropionate (BDP) and the degree of asthma control.A cohort concurrent study was carried out for 12 months with 122 asthmatic patients, aged 3-12 years, randomly selected in a pediatric pulmonology outpatient clinic, who received BDP free of charge. Adherence rates were verified by pharmacy records. Clinical control was assessed through a scoring system comprised four variables (nocturnal and morning symptoms, limitation of physical activities and exacerbations). Total score was 16 points. Patients whose score was below or equal to two were considered controlled (group 1), and patients whose score was above or equal to three were considered uncontrolled (group 2). For patients able to perform spirometry, we considered as controlled the patients with forced expiratory volume in 1 s (FEV1) equal to or above 80% of the predicted value, and as uncontrolled the patients with FEV1 below 80%.Fewer than half (40.3% maximum) of the 122 patients maintained asthma control. Median adherence rate of groups 1 and 2 were 85.5% and 33.8%, (P < 0.001) in the 4th month, 90.0% and 48.0% (P < 0.001) in the 8th month and 84.4% and 47.0% in the 12th month (P < 0.001), respectively.In all periods, there were statistically significant differences in adherence rates for maintaining or not maintaining the asthma control. Optimal asthma control entailed adherence rate higher than 80%. Strategies for reducing asthma morbidity should include a regular monitoring of adherence to inhaled steroids.