Schatz Michael, Rodriguez Eva, Falkoff Reuben, Zeiger Robert S
Division of Allergy Research, Department of Allergy, Southern California Permanente Medical Group, San Diego, California 92111, USA.
J Asthma. 2003 Feb;40(1):49-53. doi: 10.1081/jas-120017206.
Although regular follow-up is recommended for patients with asthma, the optimal frequency of such follow-up has not been defined. The purpose of this study was to evaluate the relationship of the interval between routine physician visits to asthma outcomes in patients with moderate persistent asthma.
The study population was a volunteer sample of subjects aged 18 years or older with moderate persistent asthma requiring at least moderate doses of inhaled corticosteroids who were followed for at least 6 months by one of two allergists in a large staff model HMO. Subjects were randomized to one of three groups: 1) monthly physician visits, 2) semi-annual physician visits, and 3) semiannual physician visits and monthly nurse phone calls. All subjects were advised to call their physician for questions or increased symptoms. The primary outcome variable was total asthma quality of life measured at baseline, 6 months and 12 months. Other outcome variables included specific asthma quality of life domains; spirometry, global asthma rating, satisfaction with treatment rating, and asthma resource and medication utilization during the one year of follow-up.
The final cohort included 29 patients per group. There were no significant differences between groups in baseline demographics, smoking history, spirometry, asthma quality of life, global rating, or satisfaction with treatment rating. As per the protocol, patients in the monthly physician visit group made significantly more routine visits during the study than other patients (P<.0001), but there were no other significant differences between groups in any of the other outcome variables at 6 months, 12 months, or during the year of the study.
Patients with the characteristics of those in this study do not need routine follow-up visits more often than every 6 months. Further studies will be necessary to determine optimal follow-up intervals for patients with other degrees of asthma severity and for those followed in other settings.
尽管建议对哮喘患者进行定期随访，但这种随访的最佳频率尚未确定。本研究的目的是评估中度持续性哮喘患者常规就诊间隔时间与哮喘结局之间的关系。
研究人群为年龄在18岁及以上、患有中度持续性哮喘且至少需要中等剂量吸入性糖皮质激素的志愿者样本，由大型员工模式健康维护组织（HMO）的两位过敏症专科医生之一对其进行至少6个月的随访。受试者被随机分为三组：1）每月就诊一次；2）每半年就诊一次；3）每半年就诊一次且护士每月电话随访。所有受试者均被告知如有问题或症状加重可联系医生。主要结局变量为在基线、6个月和12个月时测量的哮喘总体生活质量。其他结局变量包括特定的哮喘生活质量领域；肺活量测定、哮喘总体评分、治疗满意度评分以及随访一年期间的哮喘资源和药物使用情况。
每组最终队列包括29名患者。各组在基线人口统计学、吸烟史、肺活量测定、哮喘生活质量、总体评分或治疗满意度评分方面无显著差异。按照方案，每月就诊组的患者在研究期间进行的常规就诊显著多于其他患者（P<0.0001），但在6个月、12个月或研究期间的任何其他结局变量方面，各组之间无其他显著差异。
具有本研究中患者特征的患者不需要比每6个月更频繁的常规随访就诊。有必要进行进一步研究以确定其他哮喘严重程度患者以及在其他环境中接受随访患者的最佳随访间隔时间。
