Buchner D A, Carlson A M, Stempel D A
Integrated Therapeutics Group, Schering-Plough, Kenilworth, NJ 07033, USA.
Am J Manag Care. 1997 Jan;3(1):87-93.
Published and widely disseminated guidelines for the care and management of asthma characterize asthma as a chronic, inflammatory disease and propose specific recommendations for therapy with inhaled anti-inflammatory medications. In a retrospective analysis of medical and pharmacy claims data of approximately 28,000 asthmatic members from five managed care settings, the dominant pattern of pharmacologic therapy that emerged was the use of bronchodilators without inhaled anti-inflammatory drug therapy. In addition, a significant proportion of asthmatic patients received no prescription drug therapy for asthma. Less than one third of asthmatic patients received any anti-inflammatory therapy and the majority of these received one or two prescriptions per year. Specialist physicians were two to three times more likely than non-specialists during a study period of 1 year to prescribe an anti-inflammatory medication, and were half as likely to have their asthmatic patients experience an emergency department or hospital event. This database analysis suggests that greater conformity with guidelines and/or access to specialist physician care for asthmatic members will lead to improved patient outcomes.
已发表并广泛传播的哮喘护理和管理指南将哮喘描述为一种慢性炎症性疾病，并针对吸入性抗炎药物治疗提出了具体建议。在对来自五个管理式医疗机构的约28000名哮喘患者的医疗和药房理赔数据进行的回顾性分析中，出现的主要药物治疗模式是使用支气管扩张剂而不进行吸入性抗炎药物治疗。此外，相当一部分哮喘患者未接受任何哮喘处方药治疗。不到三分之一的哮喘患者接受了任何抗炎治疗，其中大多数患者每年接受一到两张处方。在为期1年的研究期间，专科医生开出抗炎药物的可能性是非专科医生的两到三倍，且其哮喘患者出现急诊科就诊或住院事件的可能性只有非专科医生的一半。该数据库分析表明，哮喘患者更符合指南和/或获得专科医生护理将改善患者的治疗效果。
