de Blic J, Boucot I, Pribil C, Huas D, Godard P
Service de pneumologie et allergologie pédiatrique, Assistance publique-Hôpitaux de Paris, hôpital Necker-Enfants-Malades, Paris, France.
Arch Pediatr. 2007 Sep;14(9):1069-75. doi: 10.1016/j.arcped.2007.05.001. Epub 2007 Jun 12.
Little information is available on asthma control level in children in France in general practice medicine although such control is 1 of the essential goals of treatment. The ER'Asthme survey has been set up to assess asthma control among asthmatic patients visiting their general practitioner and to determine the clinical and therapeutic associated factors.
Cross-sectional ancillary study carried out in 1410 asthmatic children aged 6 to 14 years old (B/G 65/35%), with asthma diagnosed at least 12 months earlier and visiting spontaneously their GP. It collected data on self-assessed health status, asthma control (assessed by 3-level composite score based on the Canadian consensus criteria as adapted by Anaes: optimal, acceptable and unacceptable), and compliance (PMAQ3w questionnaire) during the last 4 weeks.
Children (or their parents) answered the question about their asthma control as follow: 62% "excellent" or "fine", 31% "not very good" and 7% "poor". GPs, however, assessed asthma control as optimal in 27% of children, acceptable in 7% and unacceptable in 66%. Eighty-four per cent of children had taken a maintenance treatment. Only 57% of patients reported complete compliance with their maintenance treatment (60% in 6-12 years old vs 52% in 13-14 years old, P=0.0089). Asthma control level was significantly associated to the asthma severity (P=0.0063), type of maintenance treatment (P<0.0001) and to treatment compliance (P=0.0005).
Asthmatic children aged 6 to 14 years old (or their parents) overestimate their asthma control, which remains inadequate. Severity of asthma, compliance level and the type of maintenance treatment influence the level of asthma control.
尽管哮喘控制是治疗的基本目标之一，但在法国全科医学中，关于儿童哮喘控制水平的信息很少。ER'Asthme调查旨在评估哮喘患者在看全科医生时的哮喘控制情况，并确定相关的临床和治疗因素。
对1410名6至14岁的哮喘儿童（男/女比例为65/35%）进行横断面辅助研究，这些儿童哮喘诊断至少提前12个月，且自行前往看全科医生。收集了过去4周内自我评估的健康状况、哮喘控制情况（根据Anaes改编的加拿大共识标准通过三级综合评分评估：最佳、可接受和不可接受）以及依从性（PMAQ3w问卷）的数据。
儿童（或其父母）对哮喘控制问题的回答如下：62%为“优秀”或“良好”，31%为“不太好”，7%为“差”。然而，全科医生评估27%的儿童哮喘控制为最佳，7%为可接受，66%为不可接受。84%的儿童接受了维持治疗。只有57%的患者报告完全依从维持治疗（6至12岁儿童中为60%，13至14岁儿童中为52%，P = 0.0089）。哮喘控制水平与哮喘严重程度（P = 0.0063）、维持治疗类型（P < 0.0001）和治疗依从性（P = 0.0005）显著相关。
6至14岁的哮喘儿童（或其父母）高估了他们的哮喘控制情况，实际控制情况仍然不足。哮喘的严重程度、依从水平和维持治疗类型会影响哮喘控制水平。
