初诊支气管哮喘患者的临床特征与用药依从性的相关性研究

Correlation of Characteristics to Adherence of Treatment in Newly Asthma Diagnosed Patients

目的:探讨支气管哮喘患者的临床特征与其药物治疗依从性的关系。方法:选择深圳市第二人民医院2015年1月至2016年12月就诊的支气管哮喘患者149例进行调查问卷,并进行为期3个月的随访。通过计数装置中剩余药物的次数计算患者使用吸入糖皮质激素(ICS)/长效β2受体激动剂(LABA)的用药依从性,同时评价患者的哮喘控制问卷(ACQ)评分及肺功能状态。结果:第1个月,126例患者的用药依从性好,23例患者的用药依从性差;用药依从性与性别、年龄、病程、合并症、职业等无相关性;用药依从性好的患者具有ACQ–5评分及夜间症状重的特征,且参加疾病健康教育的比例高;用药依从性随着治疗时间的延长逐渐下降。结论:支气管哮喘患者使用ICS/LABA的依从性与患者症状的严重程度及对疾病的认知有密切关系,加强患者健康教育能有效提高患者用药依从性及疗效。

Objective To evaluate the compliance of patients with bronchial asthma and the associated factors. MethodsPatients with asthma that had undergone 3 months of follow-up were included.Drug adherence was assessed by counting the number of remaining doses in the inhaler when study medication was returned at one month interval.Poor compliance was defined as taking 80 % of the prescribed dose.ACQ-5 and lung function（FEV1, FEV1/FVC, PEF, FEF 20-75 %, and PC20） were evaluated at the beginning and each visit till the end of the follow-up. Result In the first month, 126 patients had good medication compliance and 23 patients had poor medication compliance; medication adherence was not related to gender, age, disease duration, comorbidity, occupation, etc.; patients with good medication adherence had ACQ-5 scores and characteristics of severe nighttime symptoms, and a high proportion of participating in health education of the disease; medication compliance gradually decreased with the extension of treatment time. Conclusions To reinforce the education on asthma knowledge is the most important measure to improve the compliance with the treatment for asthma.