Cowie Robert L, Underwood Margot F, Little Cinde B, Mitchell Ian, Spier Sheldon, Ford Gordon T
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Can Respir J. 2002 Jul-Aug;9(4):253-9. doi: 10.1155/2002/106262.
Asthma is common and is often poorly controlled in adolescent subjects.
To determine the impact of an age-specific asthma program on asthma control, particularly on exacerbations of asthma requiring emergency department treatment, and on the quality of life of adolescents with asthma.
The present randomized, controlled trial included patients who were 15 to 20 years of age and had visited emergency departments for management of their asthma. The interventional group attended an age-specific asthma program that included assessment, education and management by a team of asthma educators, respiratory therapists and respiratory physicians. In the control group, spirometry was performed, and the patients continued to receive usual care from their regular physicians. The outcomes were assessed by a questionnaire six months after entry into the study.
Ninety-three subjects entered the study and were randomly assigned to the intervention or control group. Of these, only 62 patients were available for review after six months. Subjects in both the control and the intervention groups showed a marked improvement in their level of asthma control, reflected primarily by a 73% reduction in the rate of emergency department attendance for asthma. Other indexes of disease control, including disease-specific quality of life, as assessed by questionnaires, were improved. There was, however, no discernible difference between the subjects in the two groups, with the exception of an improvement in favour of the intervention group in the symptom (actual difference 0.7, P=0.048) and emotional (actual difference 0.8, P=0.028) domains of the asthma quality of life questionnaire. The overall quality of life score favoured the intervention group by a clinically relevant difference of 0.6, but this difference did not reach statistical significance (P=0.06).
Although all subjects demonstrated a significant improvement in asthma control and quality of life, the improvement attributable to this intervention was limited to two domains in disease-specific quality of life.
哮喘在青少年中很常见，且病情往往控制不佳。
确定一项针对特定年龄段的哮喘项目对哮喘控制的影响，特别是对需要急诊科治疗的哮喘发作的影响，以及对哮喘青少年生活质量的影响。
本随机对照试验纳入了年龄在15至20岁之间、因哮喘管理而前往急诊科就诊的患者。干预组参加了一项针对特定年龄段的哮喘项目，该项目包括由一组哮喘教育工作者、呼吸治疗师和呼吸内科医生进行评估、教育和管理。对照组进行了肺活量测定，患者继续接受其常规医生的常规治疗。在进入研究六个月后，通过问卷调查对结果进行评估。
93名受试者进入研究并被随机分配到干预组或对照组。其中，六个月后只有62名患者可供评估。对照组和干预组的受试者在哮喘控制水平上均有显著改善，主要表现为哮喘急诊就诊率降低了73%。通过问卷调查评估的其他疾病控制指标，包括疾病特异性生活质量，也有所改善。然而，两组受试者之间没有明显差异，哮喘生活质量问卷的症状（实际差异0.7，P = 0.048）和情绪（实际差异0.8，P = 0.028）领域除外，干预组有所改善。总体生活质量评分干预组比对照组高0.6，具有临床相关性，但这一差异未达到统计学意义（P = 0.06）。
尽管所有受试者在哮喘控制和生活质量方面均有显著改善，但该干预措施带来的改善仅限于疾病特异性生活质量的两个领域。
