中国儿童哮喘行动计划对长期居家哮喘儿童管理的效果评价  

Evaluation of the efficacy of Chinese Children′s Asthma Action Plan on the long-term management of children with asthma at home

作　　者：张冰 金蓉[2] 管仁政[2] 林荣军[2] 常大芸 张兰华[3] 丁杰[3] Zhang Bing;Jin Rong;Guan Renzheng;Lin Rongjun;Chang Dayun;Zhang Lanhua;Ding Jie(Medical College of Qingdao University,QingDao 266021,China;Department of General Pediatrics,The Affiliated Hospital of Qingdao University,Qingdao 266100,China;Department of Pediatrics,Weihai Municipal Hospital,Weihai 264200,China)

机构地区：[1]青岛大学医学院,青岛266021 [2]青岛大学附属医院综合儿科,青岛266100 [3]威海市立医院儿科,威海264200

出　　处：《中华医学杂志》2020年第46期3702-3705,共4页National Medical Journal of China

基　　金：国家自然科学基金(81701587)。

摘　　要：目的:借助互联网技术及大数据了解因新冠疫情导致长期居家哮喘患儿加入中国儿童哮喘行动计划(CCAAP)的动向及哮喘控制情况,并进行效果评价。方法:采取随机整群抽样的调查方法,应用电子"问卷星"在2020年1月25日至3月31日新冠肺炎流行期间对青岛大学附属医院确诊为哮喘并加入CCAAP电子平台的患儿的一般情况、用药情况及疫情影响情况进行摸底。根据需要及用药依从性评分,依据支气管哮喘用药依从性量表设计电子问卷星调查问卷,对0~14岁确诊哮喘并加入CCAAP的患儿的家长进行电子问卷调查,对电子问卷调查结果进行统计学分析。结果:共发出初筛电子问卷423份,有效问卷422份,有效应答率99.7%。问卷调查结果显示,参与调查的患儿中男296例,占比70.1%,女126例,占比29.9%,年龄为(5.4±2.6)岁,其中男性年龄(5.3±2.6)岁,女性年龄(5.4±2.6)岁,男性大于女性。13.95%的患儿家长认为疫情对哮喘患儿有中度以上的影响。控制用药中普米克令舒占51.7%,白三烯受体拮抗剂(平奇)占66.4%。电子问卷显示使用CCAAP平台后不满意度只有1.42%,71.87%的患儿医疗费用下降,经常使用、间断使用抗生素的比例明显下降,偶尔使用及从未使用抗生素的比例明显升高( P<0.05)。用药依从性平均分4.56分,使用平台的频率越频繁,用药依从性关系评分越高( P<0.05)。 结论:借助互联网技术使用CCAAP管理后,长期居家隔离的哮喘患儿受新冠肺炎疫情影响小,用药依从性高,医疗费用普遍下降,抗生素使用明显减少,满意度很高。这种管理模式为互联网医疗提供了新思路。Objective During the COVID-19 pandemic,the electronic"questionnaire star"was employed to investigate the general situation,medication situation and pandemic impact of children diagnosed with asthma in our hospital and enrolled in the electronic platform of the Chinese Children′s Asthma Action Plan(CCAAP).The internet technology and big data were used to grasp the trend and asthma control of children who had been at home for a long time due to the pandemic,so as to facilitate the management.Methods By random cluster sampling survey method,according to the needs and medication adherence score,the electronic"questionnaire star"was designed to conduct a survey among children(0 to 14 years old)who diagnosed with asthma and joined the CCAAP on the basis of bronchial asthma medication adherence scale.Finally,the results of electronic questionnaire survey were analyzed.Results A total of 423 questionnaires were sent out,422 of which were valid,with an effective response rate of 99.7%.The results of questionnaire survey showed that 296 cases were male,accounting for 70.1%,and 126 cases were female,accounting for 29.9%,with an average age of(5.4±2.6)years old.The average age of males and females was(5.3±2.6)and(5.4±2.6)years old,respectively.There were more children aged≥5 years than children who were younger than 5 years.Additionally,13.95%of the parents thought that the pandemic had more than moderate impact on children with asthma,and 76.12%of the children were in the green zone and had no asthma attack.The proportion of green zone inhaled drugs(79.8%)was higher than yellow zone and red zone(49.8%).After using the CCAAP platform,the dissatisfaction rate was only 1.42%.Moreover,71.87%of the children′s medical expenses decreased,and the proportion of frequent use and intermittent use of antibiotics reduced,however,the proportion of occasional use and never use of antibiotics increased significantly(all P<0.05).The average score of drug compliance was 4.56,and the more frequently the platform was used,the higher t

关 键 词：哮喘 卫生计划实施 互联网+ 长期居家 

分 类 号：R725.6[医药卫生—儿科]