Roghmann M C, Sexton M
Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
J Asthma. 1999 Jun;36(4):381-7. doi: 10.3109/02770909909068231.
Adherence to asthma practice guidelines is low. Improved compliance could potentially improve care of patients with asthma. The purpose of this study was to determine if patients managed in a general practice with an associated asthma clinic are more likely to use asthma medications according to clinical practice guidelines than patients managed in the general surgery of the practice. A cross-sectional study of adult asthmatics, aged 18-55 years, was conducted in six British general practices. Prescription data on all asthma medication was collected for a 6-month period. Information on asthma clinic attendance, age, sex, employment status, other medical illness, and how patients used their inhaled beta2-agonist was collected through questionnaire. The prescription data for asthma medication and patient use of inhaled beta2-agonist were compared to the British Thoracic Society's (BTS) Guidelines for Management of Asthma in Adults to determine if the patient's asthma medication regimen was appropriate. There was no significant association found between appropriate asthma medication and asthma clinic attendance or other patient characteristics. Adherence to the BTS guidelines was low. Fifty-eight percent of the asthma patients used asthma medication regimens that were not consistent with the BTS guidelines published 1 year earlier. Adherence to the BTS guidelines was low regardless of patient characteristics, including asthma clinic attendance, age, sex, employment status, other medical illness, or individual practice. These findings underscore the need to document the utility of clinical practice guidelines which may improve physician compliance.
对哮喘诊疗指南的依从性较低。提高依从性可能会改善哮喘患者的护理。本研究的目的是确定在设有相关哮喘诊所的普通诊所接受治疗的患者，是否比在该诊所普通外科接受治疗的患者更有可能按照临床实践指南使用哮喘药物。在英国的六个普通诊所对年龄在18至55岁之间的成年哮喘患者进行了一项横断面研究。收集了为期6个月的所有哮喘药物的处方数据。通过问卷调查收集了有关哮喘诊所就诊情况、年龄、性别、就业状况、其他疾病以及患者如何使用吸入型β2激动剂的信息。将哮喘药物的处方数据和患者使用吸入型β2激动剂的情况与英国胸科学会（BTS）的《成人哮喘管理指南》进行比较，以确定患者的哮喘药物治疗方案是否合适。在合适的哮喘药物治疗与哮喘诊所就诊情况或其他患者特征之间未发现显著关联。对BTS指南的依从性较低。58%的哮喘患者使用的哮喘药物治疗方案与1年前发布的BTS指南不一致。无论患者特征如何，包括哮喘诊所就诊情况、年龄、性别、就业状况、其他疾病或个体诊所情况，对BTS指南的依从性都较低。这些发现强调了记录临床实践指南效用的必要性，这可能会提高医生的依从性。
