Associations of patient outcomes with level of asthma control
Associations of patient outcomes with level of asthma control
复制标题
DOI：
10.1016/j.anai.2012.07.024
复制
发表时间：
2012-10-01
影响因子：
5.9
通讯作者：
Sullivan, Sean D.
中科院分区：
文献类型：
--
作者：
Gold, Laura S.;Smith, Nancy;Sullivan, Sean D.
背景：尽管有有效的药物治疗，哮喘仍然是美国医疗保健系统的一个重要负担。目的：确定哮喘洞察和管理(AIM)调查的受访者中，部分和未控制的哮喘与不良后果(如就诊医疗专业人员和药物使用)是否与控制良好的哮喘相关。方法：AIM调查于2009年进行，包括2500名12岁或以上的哮喘患者。我们将患者分为控制水平，并比较哮喘控制良好的患者与哮喘部分控制和未控制的患者对医疗服务的利用和活动的限制。结果：报告收入和教育程度较低且缺乏医疗保险的患者患上控制良好的哮喘的可能性较小。与哮喘控制良好的患者相比，哮喘未得到控制的患者更有可能使用口服类固醇(优势比[OR]，2.5；95%可信区间[CI]，1.9-3.2)和非处方药(OR，2.7；95%CI，2.0-3.7)。与哮喘得到很好控制的受访者相比，哮喘部分或未得到控制的受访者报告曾去看过内科医生、专家或急诊科或因哮喘住院的可能性也明显更高(OR值从2.1到5.6)。最后，与哮喘控制良好的患者相比，哮喘未得到控制的患者报告哮喘限制其活动的几率(OR值从14到34)增加。结论：与哮喘控制良好的患者相比，部分和未控制哮喘的患者报告使用的卫生保健资源明显更多，日常活动的限制也更大。(C)2012年美国过敏、哮喘和免疫学学院。爱思唯尔公司出版，版权所有。
Background: Despite effective medications, asthma remains a significant burden to the US health care system.Objective: To determine whether partly and uncontrolled asthma in respondents to the Asthma Insights and Management (AIM) survey was associated with adverse outcomes (such as visits to health care professionals and medication use) compared with well-controlled asthma.Methods: The AIM survey, conducted in 2009, included 2,500 patients with asthma who were 12 years or older. We classified patients into levels of control and compared use of health care services and limitations of activities in patients whose asthma was well controlled vs those with partly and uncontrolled asthma.Results: Patients who reported lower income and educational status and lacked health insurance were less likely to have had well-controlled asthma. Respondents with uncontrolled asthma were more likely to report ever use of oral steroids (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.9-3.2) and over-the-counter medicine (OR, 2.7; 95% CI, 2.0-3.7) compared with patients whose asthma was well controlled. Respondents with partly and uncontrolled asthma were also significantly more likely to report ever visiting physicians, specialists, or the emergency department or being hospitalized for asthma compared with those whose asthma was well controlled (ORs ranging from 2.1 to 5.6). Finally, respondents whose asthma was uncontrolled had increased odds (ORs ranging from 14 to 34) of reporting that asthma limited their activities compared with respondents whose asthma was well controlled.Conclusion: Patients with partly and uncontrolled asthma defined by international guidelines reported use of significantly more health care resources and greater limitations of their daily activities compared with patients whose asthma was well controlled. (C) 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.