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全科医疗中儿童哮喘治疗的处方模式。

Prescribing patterns for childhood asthma treatment in general practice.

作者信息

Chan P W, Norzila M Z

机构信息

Division of Respiratory Medicine, University Malaya Medical Center, 50603 Kuala Lumpur.

出版信息

Med J Malaysia. 2003 Oct;58(4):475-81.

Abstract

The treatment preferences of 109 general practitioners (GPs) for childhood asthma were determined. Availability and adherence to clinical practice guidelines (CPG) for the treatment of childhood asthma was also assessed. Ninety eight (90%), 60 (55%) and 33 (30%) GPs considered nocturnal symptoms > 2 times/week, exercise induced wheeze and cough respectively as indications for preventer therapy. An oral preparation was preferred for relief medication [72 (66%) for 2-5 years, 60 (55%) for > 5 years]. An inhaled preparation was however preferred for preventer medication [60 (55%) for 2-5 years, 85 (78%) for > 5 years]. The oral form was more likely prescribed for asthmatic children 2-5 years (p < 0.001). Corticosteroids and ketotifen were the commonest inhaled and oral preventer treatment prescribed respectively. Only 36(33%) GPs have a CPG copy for reference. Children with asthma symptoms that require preventer therapy may not always be identified in general practice. The oral route remains important for asthma medication especially in young children. The accessibility to the CPG among GPs is disappointing.

摘要

确定了109名全科医生(GP)对儿童哮喘的治疗偏好。还评估了儿童哮喘治疗临床实践指南(CPG)的可得性和遵循情况。分别有98名(90%)、60名(55%)和33名(30%)全科医生认为每周夜间症状发作超过2次、运动诱发喘息和咳嗽是预防性治疗的指征。缓解药物首选口服制剂[2至5岁组72名(66%),5岁以上组60名(55%)]。然而,预防性药物首选吸入制剂[2至5岁组60名(55%),5岁以上组85名(78%)]。2至5岁哮喘儿童更有可能被开具口服剂型(p<0.001)。皮质类固醇和酮替芬分别是最常用的吸入和口服预防性治疗药物。只有36名(33%)全科医生有CPG副本可供参考。在全科医疗中,可能并非总能识别出需要预防性治疗的哮喘症状儿童。口服途径对哮喘药物治疗仍然很重要,尤其是对幼儿。全科医生获取CPG的情况令人失望。

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