Vilar M E, Reddy B M, Silverman B A, Bassett C W, Rao Y A, Chiaramonte L T, Schneider A T
Department of Allergy and Immunology, Long Island College Hospital, Brooklyn, New York 11201, USA.
Ann Allergy Asthma Immunol. 2000 Mar;84(3):299-303. doi: 10.1016/S1081-1206(10)62777-9.
Asthma morbidity and mortality continue to increase especially in the inner cities despite medical advances in disease management.
To investigate the clinical outcomes of inner city asthma patients treated in an allergy clinic.
Phase 1 involved random review of medical records of 100 asthma patients treated in an allergy clinic for 2 consecutive years, assessing the frequency of hospitalizations, emergency room visits (ERV) and asthma severity during three periods; 1 year prior to initial visit (year 0) and during the first (year 1) and second (year 2) years of intervention. Phase 2 involved administration of quality of life (QOL) survey to 23 patients volunteered from allergy clinic (group I), and 21 patients volunteered from emergency room (group II), treated by primary care or emergency room physicians during the previous year.
The frequency of hospitalizations and ERV significantly declined over time (P < .001) with greatest declines during year 1. Disease severity of all patients significantly declined over time (P < .001); good compliers had significant improvement over poor compliers (P < .023). Quality of life scores were significantly lower for both groups than for the general population; and although the scores were higher in the allergy clinic group than in the non-allergy clinic group, significant differences were achieved only in mental health and social functioning domains.
Patients treated in an allergy clinic demonstrate superior clinical outcomes.
尽管在疾病管理方面取得了医学进展，但哮喘的发病率和死亡率仍在持续上升，尤其是在市中心地区。
调查在过敏诊所接受治疗的市中心哮喘患者的临床结局。
第一阶段包括随机回顾连续两年在过敏诊所接受治疗的100例哮喘患者的病历，评估三个时期的住院频率、急诊室就诊（ERV）次数和哮喘严重程度；初次就诊前1年（第0年）以及干预的第一年（第1年）和第二年（第2年）。第二阶段包括对23名来自过敏诊所的志愿者患者（第一组）和21名来自急诊室的志愿者患者（第二组）进行生活质量（QOL）调查，这些患者在前一年由初级保健医生或急诊室医生治疗。
住院频率和ERV次数随时间显著下降（P <.001），在第1年下降幅度最大。所有患者的疾病严重程度随时间显著下降（P <.001）；依从性好的患者比依从性差的患者有显著改善（P <.023）。两组的生活质量得分均显著低于一般人群；尽管过敏诊所组的得分高于非过敏诊所组，但仅在心理健康和社会功能领域取得了显著差异。
在过敏诊所接受治疗的患者表现出更好的临床结局。
