McNairn Julie D K, Ramos Candace, Portnoy Jay M
Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA.
Curr Opin Allergy Clin Immunol. 2007 Jun;7(3):231-5. doi: 10.1097/ACI.0b013e32814a5583.
Many interventions have been undertaken in managing asthma in a population-based framework. The identification of successful interventions would guide policy implementation to improve outcomes in patient morbidity and mortality and healthcare costs.
Several studies have focussed on emergency room interventions in asthma management. Many support the existence of the "teachable moment" to lead to interventions that are effective. Other popular interventions are community-based educational programmes, targeting clinician and patient behavior modification. In some cases, it is unclear how these interventions impact patient-specific outcomes such as quality of life, symptom-free days, or missed days of school or work as these were not measured. Most studies separate patients on the basis of age (adults versus children), adding yet another level of complexity to the development of useful interventions.
Several of the interventions failed to show a significant improvement of patient-centered asthma outcomes when they were measured. This was despite an improvement in surrogate measures, such as attendance of follow-up appointments. Many studies did not (or were not designed to) show a durable response. Further research is needed to understand this chronic disease and devise effective interventions with appropriate outcomes for measuring their effectiveness.
在基于人群的框架下，人们采取了多种干预措施来管理哮喘。确定成功的干预措施将指导政策实施，以改善患者发病率、死亡率和医疗成本等结果。
多项研究聚焦于哮喘管理中的急诊干预。许多研究支持存在“可教时刻”，从而带来有效的干预措施。其他常见的干预措施是以社区为基础的教育项目，旨在改变临床医生和患者的行为。在某些情况下，尚不清楚这些干预措施如何影响患者特定的结果，如生活质量、无症状天数或缺课或旷工天数，因为这些并未得到测量。大多数研究根据年龄（成人与儿童）对患者进行区分，这给制定有效的干预措施又增加了一层复杂性。
在对一些干预措施进行测量时，未能显示出以患者为中心的哮喘结果有显著改善。尽管诸如随访预约的就诊率等替代指标有所改善，但情况依然如此。许多研究没有（或未设计）显示出持久的效果。需要进一步研究来了解这种慢性病，并设计出有效的干预措施以及合适的结果指标来衡量其有效性。
