Volovitz B, Friedman N, Levin S, Kertes J, Iny-Cordova S, Nussinovitch M, Meytes D, Kokia E
Department of Pediatrics C, Asthma Research and Education, Asthma Clinic, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
J Asthma. 2003 Dec;40(8):901-8. doi: 10.1081/jas-120023582.
Our objective was to investigate the impact of increased asthma awareness among primary care physicians on the asthma control and satisfaction of their patients. Physicians attended an asthma education session with emphasis on patient-physician partnership followed by 4 month monitored follow-up of patients aged 5-44 years with mild to moderate asthma. Findings were compared with a group of patients whose physician attended the session but did not participate in the follow-up and two other control groups. The study included pediatricians and general practitioners of Maccabi Healthcare Services and their patients. Asthma symptoms were rated by patients and physicians. Data on drug prescription and use were derived from the Maccabi central database. Patient response and satisfaction and physician satisfaction were evaluated by telephone interviews. Mean asthma symptom score improved from 2.0 to 1.1 in the study group of patients (p < 0.001). The use of reliever drugs decreased concomitantly with a rise in controller drugs in all patients. An improvement in asthma status was reported by 64% of the study patients and 39% of non-participating patients (p = 0.007). Fifty-eight percent of the patients rated their competence to deal with asthma as high before the intervention compared to 62% of the participating and 55% of the non-participating patients after the intervention (p = 0.002). Most physicians claimed that simply increasing their awareness on asthma led to beneficial results in their patients. Physician education followed by monitored follow-up enhanced asthma control and patient satisfaction. Nevertheless, physician education alone appears to have a significant isolated impact on asthma control.
我们的目标是调查基层医疗医生对哮喘认识的提高对其患者哮喘控制情况及满意度的影响。医生参加了一次强调医患合作关系的哮喘教育课程，随后对年龄在5至44岁的轻至中度哮喘患者进行了为期4个月的跟踪监测。研究结果与另一组医生参加了该课程但未参与跟踪监测的患者以及另外两个对照组进行了比较。该研究纳入了马卡比医疗服务公司的儿科医生和全科医生及其患者。哮喘症状由患者和医生进行评分。药物处方和使用数据来自马卡比中央数据库。通过电话访谈评估患者的反应、满意度以及医生的满意度。研究组患者的平均哮喘症状评分从2.0降至1.1（p < 0.001）。在所有患者中，缓解药物的使用随着控制药物的增加而相应减少。64%的研究组患者和39%的未参与患者报告哮喘状况有所改善（p = 0.007）。干预前，58%的患者将自己应对哮喘的能力评为高水平，相比之下，干预后参与的患者中有62%，未参与的患者中有55%将自己应对哮喘的能力评为高水平（p = 0.002）。大多数医生称，仅仅提高他们对哮喘的认识就给患者带来了有益的结果。医生接受教育并随后进行跟踪监测可增强哮喘控制和患者满意度。然而，仅医生教育似乎对哮喘控制也有显著的单独影响。
