Worldwide severity and control of asthma in children and adults: The global Asthma Insights and Reality surveys
Worldwide severity and control of asthma in children and adults: The global Asthma Insights and Reality surveys
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DOI：
10.1016/j.jaci.2004.04.042
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发表时间：
2004-07-01
影响因子：
14.2
通讯作者：
Weiss, ST
中科院分区：
文献类型：
--
作者：
Rabe, KF;Adachi, M;Weiss, ST
背景：1995年，全球哮喘防治倡议（GINA）指南推荐了哮喘管理目标，并于2002年更新。然而，最近没有关于哮喘真实的管理的国际调查。目的：哮喘洞察和现实调查是第一次大规模的调查，旨在确定儿童和成人哮喘的严重程度，控制和管理的国际差异。方法：在北美、欧洲、非洲和非洲的29个国家的家庭中，和亚洲进行了调查，以确定从一般人群哮喘患者的症状在过去一年内或谁正在服用哮喘药物。对7786名成年人进行了标准问卷调查，并通过代理人对3153名哮喘儿童进行了调查。客观和主观的哮喘控制和严重程度的病人的看法进行了评估，包括获得医疗保健，卫生保健的使用，错过了工作学校，和药物use.Results：尽管在国家一级的变化，哮喘对患者的生活有很大的影响，观察到相当大的损失的学习日和工作日。目前世界范围内的哮喘控制水平福尔斯远远低于国际指南中的长期管理目标。很大一部分病人继续有症状和生活方式的限制，并需要紧急护理。成年哮喘患者中吸烟者的比例也很高。然而，即使在严重持续性哮喘患者中，抗炎预防性药物的使用率也很低，从西欧的26%到日本的9%，客观肺功能测试的使用率也很低。自我感知的严重程度的哮喘和客观评估的严重程度的基础上GINA标准之间的相关性是一贯的穷人在所有areas.Conclusion：我们得出结论，有直接的证据表明，在全球范围内的许多患者的次优哮喘控制，尽管有效的治疗方法的可用性，长期管理失败远远低于GINA指南中设定的目标。
Background: In 1995, the Global Initiative for Asthma (GINA) guidelines recommended goals for the management of asthma, which were updated in 2002. However, there are no recent international surveys on the real management of asthma.Objective: The Asthma Insights and Reality surveys are the first large-scale surveys aimed at determining international variations in the severity, control, and management of asthma in children and adults.Methods: A cross-section of households in 29 countries in North America, Europe, and Asia were surveyed to identify from the general population asthmatic patients with symptoms within the last year or who were taking current asthma medication. A standard questionnaire was administered to 7786 adults, and, through a proxy, to 3153 children with asthma. Objective and subjective patient perception of asthma control and severity were assessed, including access to medical care, health care use, missed work-school, and medication use.Results: Despite variations at a country level, a substantial effect of asthma on patients' lives was observed, with considerable loss of schooldays and workdays. The current level of asthma control worldwide falls far short of the goals for long-term management in international guidelines. A significant proportion of patients continue to have symptoms and lifestyle restrictions and to require emergency care. The proportion of adult asthmatic patients who were current smokers was also high. However, the use of anti-inflammatory preventative medication, even in patients with severe persistent asthma, was low, ranging from 26% in Western Europe to 9% in Japan, as was the use of objective lung function testing. The correlation between self-perceived severity of asthma and objective assessment of severity on the basis of GINA criteria was consistently poor in all areas.Conclusion: We conclude that there is direct evidence for suboptimal asthma control in many patients worldwide, despite the availability of effective therapies, with long-term management failing far short of the goals set in the GINA guidelines.