The use of anti-inflammatory medications in cystic fibrosis - Trends and physician attitudes
The use of anti-inflammatory medications in cystic fibrosis - Trends and physician attitudes
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DOI：
10.1378/chest.115.4.1053
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发表时间：
1999-04-01
期刊：
影响因子：
9.6
通讯作者：
Konstan, MW
中科院分区：
文献类型：
--
作者：
Oermann, CM;Sockrider, MM;Konstan, MW
研究目的：近年来，在囊性纤维化（CF）肺疾病患者中，人们对使用抗肿瘤药物减少气道炎症和保护肺功能产生了相当大的兴趣;长期使用口服皮质类固醇（OCS）和布洛芬（IBU）已被证明在减缓CF进展方面有效。吸入性皮质类固醇（ICS）尚未得到充分研究。关于使用趋势和医生对这些药物的态度知之甚少。设计：横截面suney邮寄给111名主任的囊性纤维化中心在美国认可的囊性纤维化基金会。两页的书面问卷包括项目关于医生对抗炎药的态度，中心人口统计学，接受治疗的患者，和医生处方therapeutic.Results的数量：67调查返回（60%）。响应中心代表239名医生，为9，363名患者提供服务，其中2，234名（24%）接受常规药物治疗。8，803例患者的完整数据集可用，其中2，169例（25%）接受抗炎治疗。98名（41%）医生为413名（5%）患者开具长期口服类固醇处方，103名（42%）医生为1，032名（12%）患者开具吸入类固醇处方，108名（45%）医生为723名（8%）患者开具高剂量IBU处方以控制CF。从业者报告称，熟悉和有效性是开OCS处方的主要原因;对副作用的担忧是不开处方的主要原因。关于ICS，开处方的主要原因是熟悉和安全性，缺乏疗效被认为是不开处方的主要原因。对于IBU，疗效排名最高的原因开处方，对安全性的关注排名最高的原因不prescribing.Conclusions：抗炎药物似乎是一个未充分利用的治疗方式在CF护理。对于接受这些药物的患者数量以及开处方的护理提供者数量来说，情况确实如此。还需要进一步的研究来解决医生对抗炎药物治疗CF的长期疗效和安全性的担忧。
Study objectives: In recent years, there has been considerable interest in the use of antiinflammatory medications to decrease airway inflammation and preserve pulmonary function in patients with cystic fibrosis (CF) lung disease; Long-term use of oral corticosteroids (OCS) and ibuprofen (IBU) has been proven efficacious in slowing the progression of CF. Inhaled corticosteroids (ICS) have not been adequately studied. Little is known regarding use trends and physician attitudes toward these drugs.Design: Cross-sectional sun ey mailed to 111 directors of Cystic Fibrosis Centers in the United States accredited by the Cystic Fibrosis Foundation. The two-page written questionnaire included items regarding physicians' attitudes toward anti-inflammatories, center demographics, patients receiving therapy, and number of physicians prescribing therapy.Results: Sixty-seven surveys were returned (60%). The responding centers represented 239 physicians and served 9,363 patients, 2,234 (24%) of whom were receiving routine antiinflammatory drugs. Complete data sets were available for 8,803 patients with 2,169 (25%) receiving anti-inflammatory therapy. Ninety-eight (41%) physicians prescribed long-term use of oral steroids for 413 (5%) patients, 103 (42%) prescribed inhaled steroids for 1,032 (12%) patients, and 108 (45%) prescribed high-dose IBU for 723 (8%) patients to control CF. The practitioners reported familiarity and efficacy as the primary reasons for prescribing OCS; concerns over side effects were the major reason for not prescribing. Regarding ICS, the primary reasons for prescribing were familiarity and safety, with lack of efficacy being cited as the major reason for not prescribing. For IBU, efficacy was ranked highest among reasons for prescribing, with concern over safety being the highest ranked reason for not prescribing.Conclusions: Anti-inflammatory medications appear to be an underutilized therapeutic modality in CF care. This is true for numbers of patients receiving these drugs as well as numbers of care providers prescribing them. Additional studies will be required to address physicians' concerns regarding the long-term efficacy and safety of anti-inflammatory drugs in treating CF.