Gillissen Adrian, Lecheler Josef
Robert-Koch-Klinik, Klinikum St. Georg, Leipzig.
Med Klin (Munich). 2003 Aug 15;98(8):417-22. doi: 10.1007/s00063-003-1262-0.
Steroid phobia is regarded as a common phenomenon in the management of asthma, eventually contributing to poor compliance in these patients. The aim of this survey was to examine asthma patients (adults and children with their parents) and general practitioners (GPs) if inhaled corticosteroids are a matter of concern.
The physicians were asked what they assume, their patients would answer. To accomplish this, 407 physicians (202 GPs without subspecialty, 103 internists, 102 pediatricians) and 346 patients (245 adults, 101 children, 109 parents) were questioned using a structured questionnaire.
In contrast to patients, physicians rated inhaled corticosteroids as the medication the patients wanted primarily to get rid of (in parenthesis physician answers): adult asthmatics 17% (55%), children 19%, parents 26% (55%). The answer "side effects" to the question "What do you dislike most in your asthma medication?" was given as follows: physicians 58%, adult asthmatics 42%, children 10%, parents 14%, and pediatricians 46%. Major lack of knowledge regarding the use and function of asthma medication was excluded in these patients as well as in the children's parents. The request for further information regarding their disease varied: adult asthmatics 57%, children 66%, parents 90%.
Our survey indicates that physicians may overestimate patients' concern to use inhaled corticosteroids in asthma therapy. For patients rejecting corticosteroid therapy other antiinflammatory treatment options must be considered as an alternative individually.
在哮喘管理中，类固醇恐惧症被视为一种常见现象，最终导致这些患者的依从性较差。本次调查的目的是研究哮喘患者（成人及儿童及其父母）和全科医生（GPs）是否担心吸入性糖皮质激素。
询问医生他们认为患者会给出的答案。为此，使用结构化问卷对407名医生（202名无亚专业的全科医生、103名内科医生、102名儿科医生）和346名患者（245名成人、101名儿童、109名父母）进行了询问。
与患者不同，医生将吸入性糖皮质激素列为患者最想停用的药物（括号内为医生的回答）：成年哮喘患者为17%（55%），儿童为19%，父母为26%（55%）。对于“你最不喜欢哮喘药物的什么？”这一问题，回答“副作用”的比例如下：医生为58%，成年哮喘患者为42%，儿童为10%，父母为14%，儿科医生为46%。这些患者以及儿童的父母不存在对哮喘药物使用和功能的重大知识缺乏。关于其疾病的进一步信息需求各不相同：成年哮喘患者为57%，儿童为66%，父母为90%。
我们的调查表明，医生可能高估了患者对哮喘治疗中使用吸入性糖皮质激素的担忧。对于拒绝糖皮质激素治疗的患者，必须分别考虑其他抗炎治疗选择作为替代方案。
