Patterns of inhaled antiinflammatory medication use in young underserved children with asthma
Patterns of inhaled antiinflammatory medication use in young underserved children with asthma
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DOI：
10.1542/peds.2006-1630
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发表时间：
2006-12-01
期刊：
影响因子：
8
通讯作者：
Bollinger, Mary E.
中科院分区：
文献类型：
--
作者：
Butz, Arlene M.;Tsoukleris, Mona;Bollinger, Mary E.
背景。哮喘指南提倡将吸入性皮质类固醇作为持续性哮喘的基础治疗，然而一些研究报告称，吸入性皮质类固醇在持续性哮喘儿童中的使用不足。此外，很少有研究使用客观的药学数据来衡量哮喘药物的可用性。我们使用药房记录作为哮喘药物的来源，研究了与持续哮喘治疗不足的年轻儿童吸入皮质类固醇使用相关的因素。本研究对一项雾化器教育干预随机临床试验参与者的问卷调查和12个月期间的药房记录数据进行了横断面分析。尽管吸入>= 1皮质类固醇补剂的暴露率高达72%，但5名持续性哮喘患儿中有1人在12个月内没有服用药物或仅服用短效受体激动剂补剂。只有20%的儿童在12个月内获得了>= 6吸入皮质类固醇填充物。在回归模型中，在控制儿童年龄、哮喘严重程度、急诊科就诊次数、制定哮喘行动计划和寻求儿童哮喘预防性护理的情况下，在12个月内获得>= 3的吸入皮质类固醇填充物与短效β受体激动剂填充物的增加和接受专科护理显著相关。在这组患有持续性哮喘的幼儿中，过度依赖短效β受体激动剂和吸入性皮质类固醇药物的使用不足是常见的。只有五分之一的儿童获得了足够的控制者药物。
BACKGROUND. Asthma guidelines advocate inhaled corticosteroids as the cornerstone treatment of persistent asthma, yet several studies report underuse of inhaled corticosteroids in children with persistent asthma. Moreover, few studies use objective pharmacy data as a measure of drug availability of asthma medications. We examined factors associated with the use of inhaled corticosteroids in young underserved children with persistent asthma using pharmacy records as their source of asthma medications.METHODS. This was a cross-sectional analysis of questionnaire and pharmacy record data over a 12-month period from participants enrolled in a randomized clinical trial of a nebulizer educational intervention.RESULTS. Although exposure to >= 1 inhaled corticosteroids refill was high at 72%, 1 of 5 children with persistent asthma had either no medication or only short-acting beta agonist fills for 12 months. Only 20% of children obtained >= 6 inhaled corticosteroids fills over 12 months. Obtaining >= 3 inhaled corticosteroids fills over 12 months was significantly associated with an increase in short-acting beta agonist fills and receiving specialty care in the regression models while controlling for child age, asthma severity, number of emergency department visits, having an asthma action plan, and seeking preventive care for the child's asthma.CONCLUSIONS. Overreliance on short-acting beta agonist and underuse of inhaled corticosteroid medications was common in this group of young children with persistent asthma. Only one fifth of children obtained sufficient controller medication fills.