Mann M, Eliasson O, Patel K, ZuWallack R L
Section on Pulmonary Diseases, Saint Francis Hospital and Medical Center, Hartford, CT.
Chest. 1992 Feb;101(2):496-9. doi: 10.1378/chest.101.2.496.
Noncompliance with inhaled steroids is a well-recognized problem in asthma therapy. We compared compliance with bid and qid regimens of inhaled flunisolide in 16 asthmatic subjects. Patients were instructed to take four inhalations bid for T1 to establish baseline compliance. During T2, half (group A) continued this dosing regimen, while the other half (group B) switched to two inhalations qid. Group A compliance did not significantly change from T1 to T2. The percentage of days with less than eight inhalations (underuse) for group B, however, increased from 20.2 +/- 40.3 in T1 (bid dosing) to 57.1 +/- 49.6 in T2 (qid dosing) (p less than 0.001). Concomitantly, the number of daily inhalations decreased from 7.9 +/- 2.5 to 6.8 +/- 3.1 (p less than 0.01). Reduced compliance with qid dosing was due in large part to an increase in frequency of six inhalations per day, resulting from tid use. Compliance with inhaled flunisolide, therefore, was worse with qid than bid dosing.
在哮喘治疗中，不依从吸入性类固醇是一个公认的问题。我们比较了16名哮喘患者吸入氟尼缩松每日两次（bid）和每日四次（qid）给药方案的依从性。指导患者在T1阶段每日两次吸入四次以建立基线依从性。在T2阶段，一半患者（A组）继续该给药方案，而另一半患者（B组）改为每日四次吸入两次。A组的依从性从T1到T2没有显著变化。然而，B组每日吸入少于八次（用药不足）的天数百分比从T1（每日两次给药）时的20.2±40.3增加到T2（每日四次给药）时的57.1±49.6（p<0.001）。同时，每日吸入次数从7.9±2.5降至6.8±3.1（p<0.01）。每日四次给药依从性降低主要是由于每日三次用药导致每日吸入六次的频率增加。因此，每日四次给药时氟尼缩松的依从性比每日两次给药时更差。
