Declining incidence of episodes of asthma: a study of trends in new episodes presenting to general practitioners in the period 1989-98
Declining incidence of episodes of asthma: a study of trends in new episodes presenting to general practitioners in the period 1989-98
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DOI：
10.1136/thorax.55.8.657
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发表时间：
2000-08-01
期刊：
影响因子：
10
通讯作者：
Ross, AM
中科院分区：
文献类型：
--
作者：
Fleming, DM;Sunderland, R;Ross, AM
背景-一项研究是为了确定参加皇家全科医师学院每周回报服务的全科医师新发哮喘发作的发病率趋势，该研究包括92个诊所，注册人口约68万人，分布在英格兰和威尔士。这些做法监测发病率提出在每一个咨询，区分新发作的疾病和正在进行的咨询。方法-特定年龄每周率的新发作的哮喘（和急性支气管炎）提出了全科医生在1989年至1998年进行了检查，在四周的块和多元回归分析，结果哮喘发作的二次趋势在每个年龄组中明显，高峰在1993/4年。对急性支气管炎的相应分析显示了类似的趋势，一般在1993/4年冬季达到高峰。自1993年以来，所有季度的每周平均发病率数据（所有年龄合并）均有所下降。区域分析（北/中/南）显示类似的decreases. Conclusions，有哮喘发作和急性支气管炎的发病率逐渐下降，自1993年以来，全科医生。1993年之前的上升趋势随后下降，不能用医疗保健使用模式或医生诊断偏好的变化来解释。
Background-A study was undertaken to determine trends in the incidence of new episodes of asthma presented to general practitioners participating in the Weekly Returns Service of the Royal College of General Practitioners, comprising 92 practices with a registered population of approximately 680 000 persons well distributed throughout England and Wales. These practices monitor the morbidity presented at every consultation, distinguishing between new episodes of illness and ongoing consultations.Methods-Age specific weekly rates of new episodes of asthma (and of acute bronchitis) presenting to the general practitioners over the years 1989-98 were examined in four week blocks and analysed by multiple regression, separating secular from seasonal trends.Results-Quadratic trends in episodes of asthma were evident in each of the age groups with peaks in 1993/4. Corresponding analyses for acute bronchitis disclosed similar trends generally peaking in the winter of 1993/4. Mean weekly incidence data (all ages combined) decreased in all quarters since 1993. Regional analysis (North/Central/South) showed similar decreases.Conclusions-There has been a gradual decrease in the incidence of asthma episodes and of acute bronchitis presenting to general practitioners since 1993. The trend of an increase before 1993 followed by a decrease cannot be explained by changes in the patterns of health care usage or diagnostic preference of doctors.