Ulrik Charlotte Suppli, Backer Vibeke, Søes-Petersen Ulrik, Lange Peter, Harving Henrik, Plaschke Peter P
Department of Heart and Lung Diseases, Hvidovre Hospital, Copenhagen, Denmark.
J Asthma. 2006 Nov;43(9):701-4. doi: 10.1080/02770900600925569.
Adherence with controller therapy poses a major challenge to the effective management of persistent asthma. The aim of this study was to explore the patient-related aspects of adherence among adult asthmatics.
The participants (n = 509 adult asthmatics), recruited from all parts of Denmark, answered the questionnaire concerning asthma knowledge, attitudes, adherence, and treatment through the Internet.
A total of 67% of the patients were prescribed inhaled corticosteroids (ICS). However, according to Global Initiative for Asthma (GINA)-guidelines' symptom severity classification, 85% should have been on ICS. Accidental and intentional non-adherence with ICS at least twice a week was reported by 27% and 24%, respectively. In case of deterioration, 60% of the patients preferred to take more reliever medication, instead of increasing the ICS dose. Having a fixed daily routine with regard to medication and following the advice given by their doctor were the main reasons for adherence, whereas lack of perceived symptoms was the main reason for non-adherence. Non-adherence was associated with increasing disagreement with the statements that controller therapy is effective (p < 0.04), as well as an essential part of asthma therapy (p < 0.002).
Both accidental and intentional non-adherence with controller therapy is common among adult asthmatics. The reasons for suboptimal adherence seem to be accessible through education of both patients and caregivers.
坚持使用控制药物治疗对持续性哮喘的有效管理构成重大挑战。本研究旨在探讨成年哮喘患者中与坚持治疗相关的患者因素。
参与者（n = 509 名成年哮喘患者）来自丹麦各地，通过互联网回答了有关哮喘知识、态度、坚持治疗情况及治疗的问卷。
共有67%的患者被处方吸入性糖皮质激素（ICS）。然而，根据全球哮喘防治创议（GINA）指南的症状严重程度分类，85%的患者本应使用ICS。分别有27%和24%的患者报告每周至少有两次意外和故意不坚持使用ICS的情况。在病情恶化时，60%的患者更倾向于增加缓解药物的使用，而非增加ICS剂量。有固定的每日用药常规以及遵循医生的建议是坚持治疗的主要原因，而感觉无症状是不坚持治疗的主要原因。不坚持治疗与对控制药物治疗有效（p < 0.04）以及是哮喘治疗的重要组成部分（p < 0.002）这两种说法的分歧增加相关。
成年哮喘患者中，意外和故意不坚持使用控制药物治疗的情况都很常见。通过对患者及其护理人员进行教育，似乎可以找到依从性欠佳的原因。
