Farber Harold J, Capra Angela M, Finkelstein Jonathan A, Lozano Paula, Quesenberry Charles P, Jensvold Nancy G, Chi Felicia W, Lieu Tracy A
Department of Pediatrics, Kaiser Permanente Vallejo Medical Center, Vallejo, California 94589, USA.
J Asthma. 2003 Feb;40(1):17-25. doi: 10.1081/jas-120017203.
Nonadherence to regular inhaled anti-inflammatory medication use is a frequent contributor to poor control of persistent asthma and may result from misunderstanding of the preventive role of such medications. This study's aims are to 1) test the hypothesis that misunderstanding is associated with decreased adherence to its daily use and 2) identify factors associated with increased risk of misunderstanding.
A sample of parents of children with asthma insured by Medicaid and enrolled in managed care programs in Northern California, Washington, and Massachusetts were interviewed by telephone. This analysis focused on the subset that reported having an inhaled anti-inflammatory medication and whose medication use and symptom frequency in the 2 weeks before the interview suggested persistent asthma. Misunderstanding of the role of inhaled anti-inflammatory medication was defined as identifying it as being for treatment of symptoms after they begin and not for prevention of symptoms before they start.
A total of 1663 parents of children with asthma (63% response rate) were interviewed. Of those, 571 subjects (34%) reported use of an inhaled anti-inflammatory medication and met our criteria for persistent asthma. Among those with persistent asthma, 23% (131 parents) misunderstood the role of their child's inhaled anti-inflammatory. Misunderstanding of inhaled anti-inflammatory medication was associated with decreased adherence to its daily use (odds ratio [OR] 0.18, 95% confidence interval [CI], 0.11-0.29). The risk for misunderstanding was lower if the patient had seen a specialist (OR 0.42, 95% CI, 0.24-0.75) or had graduated high school (OR=0.54, 95% CI, 0.34-0.84).
Misunderstanding of the role of inhaled anti-inflammatory medication is associated with reduced adherence to its daily use.
不坚持规律使用吸入性抗炎药物是导致持续性哮喘控制不佳的常见原因，可能是由于对这类药物的预防作用存在误解。本研究的目的是：1）检验误解与日常用药依从性降低相关的假设；2）确定与误解风险增加相关的因素。
通过电话访谈了加利福尼亚州北部、华盛顿州和马萨诸塞州参加医疗补助计划并加入管理式医疗项目的哮喘患儿的家长样本。本分析聚焦于报告使用吸入性抗炎药物且在访谈前两周的用药情况和症状频率表明患有持续性哮喘的子集。对吸入性抗炎药物作用的误解定义为将其视为症状出现后用于治疗而非症状出现前用于预防。
共访谈了1663名哮喘患儿的家长（应答率为63%）。其中，571名受试者（34%）报告使用了吸入性抗炎药物并符合我们对持续性哮喘的标准。在患有持续性哮喘的患者中，23%（131名家长）误解了其孩子吸入性抗炎药物的作用。对吸入性抗炎药物的误解与日常用药依从性降低相关（优势比[OR]为0.18，95%置信区间[CI]为0.11 - 0.29）。如果患者看过专科医生（OR为0.42，95%CI为0.24 - 0.75）或高中毕业（OR = 0.54，95%CI为0.34 - 0.84），误解的风险较低。
对吸入性抗炎药物作用的误解与日常用药依从性降低相关。
