ASTHMA EDUCATION SYMPTOMS AND AIRWAY INFLAMMATION

哮喘教育症状和气道炎症

• 批准号: 2393027
• 负责人: Susan L Janson
• 金额: $ 22.58万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-04-10 至 1999-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2393027
• 关键词: asthma; behavioral /social science research tag; biomarker; bronchodilators; clinical research; clinical trial phase I; corticosteroids; disease /disorder prevention /control; health behavior; health education; human subject; human therapy evaluation; inflammation; inhalation drug administration; nursing intervention; patient care management; prognosis; respiratory function; self care; sign /symptom; spirometry; theophylline; young adult human (21-34)

Asthma is a serious, chronic, and potentially life-threatening disease affecting 10-13 million persons in the United States. The disease has major societal impact, causing, restricted activity due to symptoms and millions of outpatient visits per year. Airway inflammation is thought to be a critical and central component of asthma pathogenesis. Current management approaches require that patients correctly carry out complex treatment regimens. However, these approaches depend heavily on the patient's understanding and skill in carrying out self-management to decrease asthma complications. Asthma education is mandated for all people with asthma (National Asthma Education Program, 1991) but must be accomplished efficiently as part of routine medical care. The overall objective of this project is to study the impact of an Asthma Education Intervention, designed to fit the context of the usual medical care appointment, on clinical markers of asthma control and biological markers of airway inflammation in samples of induced sputum. Clinical markers of asthma control include measures of symptom intensity, pulmonary function, and frequency of inhaled beta agonist use. These markers are affected by successful self-management through consistent and correct use of inhaled medication. The primary clinical outcome of this study is reduction of symptom intensity. Biological markers of airway inflammation include cell counts, differential eosinophilic cationic protein (ECP), and albumin in sputum of asthmatic subjects. The primary biological outcome of this study is reduction of the reduction of the concentration of ECP in sputum. The specific aims are: (1) to test the impact of the Asthma Patient Education Intervention on the primary clinical outcome, symptom intensity, and the primary biological outcome, concentration of (ECP) in sputum samples; and, (2) to describe the effect of the Asthma Education Intervention on secondary clinical and biological markers of asthma control: peak flow, frequency of beta agonist use, pulmonary function, and quantity of eosinophils, neutrophils, and albumin in induced sputum samples of asthmatics. The findings of this study will lead to further refinement and selection of useful outcomes to monitor the effect of asthma educational interventions. A prospective, randomized control trial will be used with 54 adult subjects with asthma assigned to an Intervention or Control group. The Intervention group will receive a 30-minute Asthma Education Intervention, with Information and behavioral components, which is repeated three times at two week intervals. Symptoms, peak flow, and beta agonist frequency will be recorded daily, pulmonary function will be recorded at each of 5 visits over 9 weeks, and constituents of sputum will be analyzed pre- and post- intervention. The long term contribution of this project is to improve control of asthma by providing patients with essential information and skills needed to self-manage the illness, and to determine the usefulness of monitoring biological as well as clinical outcomes of nursing intervention.

哮喘是一种严重的慢性疾病，可能危及生命 影响美国1000 - 1300万人。 这种疾病已经 严重的社会影响，导致，由于症状和 每年有数百万的门诊病人。 气道炎症被认为是 是哮喘发病机制的关键和核心组成部分。 电流 管理方法要求患者正确执行复杂的 治疗方案。 然而，这些方法严重依赖于 病人对自我管理的理解和技巧， 减少哮喘并发症。 对所有哮喘患者进行哮喘教育是强制性的（国家哮喘 教育计划，1991年），但必须有效地完成的一部分， 常规医疗护理。 本项目的总体目标是研究 哮喘教育干预的影响，旨在适应环境 常规医疗预约，哮喘的临床标志物 在诱导的肺组织样品中的气道炎症的对照和生物标志物 痰 哮喘控制的临床指标包括症状的测量 强度、肺功能和吸入性β受体激动剂使用频率。 这些标志物受到成功的自我管理的影响， 正确使用吸入式药物。 主要临床结局 这项研究是减轻症状强度。 气道生物标志物 炎症包括细胞计数、嗜酸性粒细胞阳离子 蛋白（ECP）和白蛋白。 主 这项研究的生物学结果是减少减少的减少， 痰液中ECP浓度。 具体目的是：（1）测试哮喘患者的影响 对主要临床结局、症状强度、 和主要生物学结局，痰中ECP浓度 描述哮喘教育的效果 哮喘次要临床生物学指标的干预 对照：峰值流量、β激动剂使用频率、肺功能，以及 诱导痰样本中嗜酸性粒细胞、中性粒细胞和白蛋白的数量 哮喘患者的症状 这项研究的结果将导致进一步的细化 和选择有用的结果来监测哮喘的影响 教育干预。 一项前瞻性随机对照试验将使用54名成人受试者 哮喘患者被分配到干预组或对照组。 干预 小组将接受30分钟的哮喘教育干预， 信息和行为成分，每两分钟重复三次 周间隔。 症状，峰值流量和β激动剂频率将 每日记录，将在5次访视中记录肺功能 9周以上，并将在治疗前和治疗后分析痰液成分。 干预 该项目的长期贡献是改善 通过向患者提供基本信息来控制哮喘， 自我管理疾病所需的技能，并确定 监测生物学和临床结果的护理 干预