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[基层医疗患者哮喘控制的相关因素:CHAS研究]

[Factors associated with asthma control in primary care patients: the CHAS study].

作者信息

González Barcala Francisco Javier, de la Fuente-Cid Ramón, Alvarez-Gil Rosa, Tafalla Mónica, Nuevo Javier, Caamaño-Isorna Francisco

机构信息

Servicio de Neumología, Hospital Clínico, Santiago de Compostela, España.

出版信息

Arch Bronconeumol. 2010 Jul;46(7):358-63. doi: 10.1016/j.arbres.2010.01.007. Epub 2010 Mar 15.

Abstract

BACKGROUND

Asthma control is inadequate in all populations studied to date, leading to a major part of the cost of the disease. The aim of our study was to evaluate the prevalence of uncontrolled asthma in primary care patients and identify the associated factors.

METHODS

We carried out a cross-sectional study of the population of primary care asthmatic patients over 18 years old in Spain (n=2159). Asthma control was measured with the Asthma Control Questionnaire (ACQ). The sociodemographic variables and treatment compliance were measured using a questionnaire. We built logistic-regression models using Asthma control, a dichotomous variable generated from ACQ score.

RESULTS

The prevalence of uncontrolled asthma was 63.9%. Treatment with oral corticosteroids (OCS) (OR=6.55), greater asthma severity (OR=3.11), presence of a distressing event (OR=2.44), lower significance given to treatment compliance (OR=1.66) and living in a rural area (OR=1.29) are associated with uncontrolled asthma. On the contrary, sex, age, obesity, smoking, alcohol intake and educational level had no effect on asthma control.

CONCLUSIONS

In Spain asthma is still uncontrolled and some factors leading to this situation appear to be modifiable by the health system.

摘要

背景

在迄今为止所有研究的人群中,哮喘控制情况均不理想,这导致了该疾病成本的很大一部分。我们研究的目的是评估基层医疗患者中未控制哮喘的患病率,并确定相关因素。

方法

我们对西班牙18岁以上的基层医疗哮喘患者人群进行了横断面研究(n = 2159)。使用哮喘控制问卷(ACQ)来衡量哮喘控制情况。使用问卷来测量社会人口统计学变量和治疗依从性。我们使用哮喘控制(一个由ACQ评分生成的二分变量)建立了逻辑回归模型。

结果

未控制哮喘的患病率为63.9%。口服糖皮质激素(OCS)治疗(OR = 6.55)、哮喘严重程度更高(OR = 3.11)、存在令人痛苦的事件(OR = 2.44)、对治疗依从性重视程度较低(OR = 1.66)以及生活在农村地区(OR = 1.29)与未控制哮喘相关。相反,性别、年龄、肥胖、吸烟、饮酒和教育水平对哮喘控制没有影响。

结论

在西班牙,哮喘仍未得到控制,导致这种情况的一些因素似乎可由卫生系统进行调整。

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