哮喘患者缓解期吸入糖皮质激素治疗依从性调查分析  

Factors related to adherence of inhaled corticosteroid therapy in asthma patients in remission period

作　　者：李新霞[1] 马迎民[1] 方秋红[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院呼吸与危重症医学科,100038

出　　处：《北京医学》2012年第2期101-103,共3页Beijing Medical Journal

摘　　要：目的调查哮喘患者缓解期吸入糖皮质激素治疗的依从性,分析相关因素。方法随机选取134例2007年1月至2010年1月在我院呼吸科门诊和住院确诊的哮喘患者,通过电话或在门诊、病房调查其缓解期对吸入糖皮质激素治疗的依从性。结果 104例(77.6%)患者曾自行停用吸入糖皮质激素治疗,仅有30例(22.4%)患者能够一直坚持用药,但其中有6名患者有自行调整用药剂量的行为。停药的原因包括症状缓解(63.5%)、担心不良反应(50%)、间断按需使用(34.6%)、自认为治疗无效(19.2%)、感觉药粉未能吸入(13.5%)、担心糖皮质激素依赖(5.8%)、经济原因(7.7%)、社区医生错误指导(3.8%),无特殊原因而停药者占1.0%,无因不会用该吸入装置或买药不方便而停药的患者。坚持用药的原因包括因曾经停药后急性发作从此坚持用药(36.7%),担心停药后复发(23.3%),听从医师宣教坚持用药(66.7%),自认为治疗有效(6.7%)。结论哮喘患者缓解期吸入糖皮质激素治疗的依从性差。应继续加强对哮喘患者个性化的健康教育并建立哮喘患者之间的交流平台,提高患者依从性,使患者受益。此外还应该加强社区医生哮喘诊治知识的更新,提高对吸入糖皮质激素治疗在支气管哮喘治疗中地位的认识,避免错误指导患者。Objective To investigate the adherence to inhaled corticosteroid therapy in patients with stable asthma ,and to identify the factors related to the compliance to this therapy. Methods Questionnaire survey by phone or personal interview were conducted in 134 in-patients and out-patients who were diagnosed as asthma from January 2007 to January 2010. Results 104 of 134 asthma patients had ever discontinued the inhaled corticosteroids therapy （77.6%）. Only 30 （22.4%） asthma patients adhered to the therapy of inhaled cortieosteroids while 6 of whom had ever adjusted the ICS dosage by themselves. The factors on discontinuation of inhaled corticosteroids included symptom alleviation （63.5%）, concerning about the side-effects（58%）, ineffective （19.2%）, use as needed（34.6%）, fail to inhale the drug（13.5%）, worrying about addiction to cortieosteroid （5.8%）, misguided by primary care doctors （3.8%）, and economic reason （7.7%）. One patient stopped the medication with no reason （1.0%）. Not knowing how to use the inhaler device and thought inconvenience to get the ICS were not related to the adherance. The reasons for adhering to ICS treatment involved worrying about relapse （23.3%）, experience of successful control of the symptoms （6.7%） and following the instruction of physicians （66.7%）. Eleven patients ever experenced astham exacerbation after discontinue ICS therapy （36.7%）. Conclusions High rate of nonadherence to inhaled corticosteroid is observed in asthma patients during the remission period. In order to improve the therapy compliance and maintain better asthma control, insisting on the individual health education and establishing a communication platform for asthma patients is absolutely necessary. Meanwhile, primary care doctors need to update their knowledge of asthma treatment to avoid wrong information to patients.

关 键 词：哮喘 缓解期 糖皮质激素 依从性 

分 类 号：R562.25[医药卫生—呼吸系统]