ASTHMA EDUCATION, SYMPTOMS AND AIRWAY INFLAMMATION

哮喘教育、症状和气道炎症

• 批准号: 2902326
• 负责人: Susan L Janson
• 金额: $ 35.59万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-07-01 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2902326
• 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、慢性且可能危及生命的疾病 影响美国 10-1300 万人。 该病有 重大社会影响，由于症状和原因导致活动受限 每年门诊量达数百万人次。 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。 当前的 管理方法要求患者正确地进行复杂的 治疗方案。 然而，这些方法在很大程度上取决于 患者进行自我管理的理解和技能 减少哮喘并发症。 所有哮喘患者都必须接受哮喘教育（国家哮喘协会 教育计划，1991），但必须作为 常规医疗护理。 该项目的总体目标是研究 旨在适应具体情况的哮喘教育干预措施的影响 常规医疗预约、哮喘临床标志物 诱导样本中气道炎症的控制和生物标志物 痰。 哮喘控制的临床标志包括症状测量 吸入β受体激动剂的使用强度、肺功能和频率。 这些标记受到通过一致的成功自我管理的影响 以及正确使用吸入药物。 主要临床结果 这项研究的目的是减轻症状强度。 气道生物标志物 炎症包括细胞计数、嗜酸性粒细胞阳离子差异 哮喘受试者痰中的蛋白质（ECP）和白蛋白。 初级 这项研究的生物学结果是减少了 痰中ECP的浓度。 具体目的是：（1）测试对哮喘患者的影响 对主要临床结果、症状强度、 以及主要生物学结果，痰中 (ECP) 的浓度 样品； (2) 描述哮喘教育的效果 对哮喘次要临床和生物学标志物的干预 控制：峰值流量、β受体激动剂使用频率、肺功能和 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。 这项研究的结果将导致进一步完善 以及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在 54 名成年受试者中进行 患有哮喘的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，其中 信息和行为成分，每两分钟重复三遍 周间隔。 症状、峰值流量和 β 激动剂频率将 每日记录，每 5 次就诊时记录肺功能 超过 9 周，并将在治疗前和治疗后对痰液成分进行分析 干涉。 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 自我管理疾病和确定有用性所需的技能 监测护理的生物学和临床结果 干涉。