Morell Ferran, Genover Teresa, Reyes Leonardo, Benaque Esther, Roger Alex, Ferrer Jaume
Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Centre d'Assistència Primària San Rafael (SAP Muntanya), Barcelona, España.
Arch Bronconeumol. 2007 Jan;43(1):29-35. doi: 10.1016/s1579-2129(07)60017-2.
Poor control of asthma treated in outpatient settings has been demonstrated. The aim of this study was to perform a short intervention, readily replicable in everyday practice, to try to improve control of the disease.
Two primary health care clinics made appointments with asthma patients to administer a questionnaire and adapt their treatment to the guidelines of the Global Initiative for Asthma. Patients also received an explanation of the disease lasting not more than 5 minutes. The protocol was repeated at a second visit 4 months later. Health care parameters were compared with those from the previous visit.
The characteristics of the 180 patients were as follows: 70% were women, 17% were smokers, 8% were illiterate, 46% had only primary education, 45% were in contact with cleaning products, and 63% had extrinsic asthma. The asthma severity was as follows: mild in 73%, moderate in 23%, and severe in 4%. Twenty-two percent had received previous explanations of the disease, 50% had a written treatment plan, 14% had a plan for exacerbations, and 54% were taking inhaled corticosteroids. The second appointment was kept by 110 (61%) of the patients, who showed differences with respect to the previous visit 4 months earlier in the percentage taking inhaled corticosteroids (78%, P< .001), the number of visits to the physician (P< .01), visits to the physician due to exacerbations (P< .001), emergency visits to the outpatient clinic (P< .002), and disease severity (P< .02).
This minimal clinical intervention reduced the need for visits to health care centers and improved the control of asthma symptoms.
门诊治疗的哮喘控制不佳已得到证实。本研究的目的是进行一项简短的干预措施，该措施在日常实践中易于复制，以试图改善疾病的控制情况。
两家初级医疗保健诊所与哮喘患者预约，以便发放问卷并使其治疗符合全球哮喘防治创议的指南。患者还接受了不超过5分钟的疾病解释。该方案在4个月后的第二次就诊时重复实施。将医疗保健参数与前一次就诊时的参数进行比较。
180名患者的特征如下：70%为女性，17%为吸烟者，8%为文盲，46%仅接受过小学教育，45%接触清洁产品，63%患有外源性哮喘。哮喘严重程度如下：轻度占73%，中度占23%，重度占4%。22%曾接受过疾病解释，50%有书面治疗计划，14%有加重发作预案，54%正在使用吸入性糖皮质激素。110名（61%）患者进行了第二次就诊，他们在使用吸入性糖皮质激素的比例（78%，P<0.001）、看医生的次数（P<0.01）、因病情加重看医生的次数（P<0.001）、门诊急诊次数（P<0.002）以及疾病严重程度（P<0.02）方面与4个月前的前一次就诊存在差异。
这种最小化的临床干预减少了前往医疗保健中心就诊的需求，并改善了哮喘症状的控制。
