Division of Pharmacoepidemiology & Clinical Pharmacotherapy, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Pediatr Allergy Immunol. 2011 Dec;22(8):776-83. doi: 10.1111/j.1399-3038.2011.01188.x. Epub 2011 Jul 13.
Several studies have shown that predictors of asthma treatment outcomes differ depending on the definition of the outcome chosen. This provides evidence that different outcomes studied may reflect distinct aspects of asthma control. To assess predictors of asthma control, we need firm outcome phenotypes. The aim of this study was to investigate the association between measurements of current and long-term asthma control.
We included 527 children using inhaled corticosteroids participating in the Pharmacogenetics of Asthma medication in Children: Medication with ANti-inflammatory effects cohort. Current asthma control (previous week) was defined using the Asthma Control Questionnaire. Long-term asthma control was based on Global Initiative for Asthma guidelines. Not well-controlled asthma in a season was defined as ≥ 3 of the following items present in a season: (i) day-time or (ii) night-time symptoms, (iii) limitations in activities, and (iv) rescue medication use. Asthma control during (i) the previous season and (ii) the year preceding the pharmacy visit was used as long-term asthma control definitions. Current and long-term asthma control were compared to investigate agreement.
Long-term uncontrolled asthma rates were highest in autumn and winter (50%) and lowest in summer (32%) (p < 0.05). Overall agreement between current and long-term asthma control was limited (66% for previous season and 68% for previous year).
Congruence between current and long-term asthma control was limited. Furthermore, we showed significant seasonal differences. It is therefore important to calculate asthma control over a longer period of time, instead of using current asthma control as indicator.
多项研究表明，哮喘治疗结局的预测因素因所选择的结局定义而异。这表明不同的研究结局可能反映了哮喘控制的不同方面。为了评估哮喘控制的预测因素，我们需要明确的结局表型。本研究旨在探讨当前和长期哮喘控制之间的关联。
我们纳入了 527 名使用吸入性皮质激素的儿童，他们参与了儿童哮喘药物的药物遗传学：抗炎作用的队列研究。当前哮喘控制（前一周）使用哮喘控制问卷进行定义。长期哮喘控制基于全球哮喘倡议指南。一个季节中控制不佳的哮喘定义为一个季节中存在以下 3 项或以上的项目：（i）日间或（ii）夜间症状，（iii）活动受限，和（iv）急救药物使用。（i）前一个季节和（ii）在就诊前一年的哮喘控制作为长期哮喘控制的定义。比较当前和长期哮喘控制以调查一致性。
秋季和冬季的长期未控制哮喘发生率最高（50%），夏季最低（32%）（p<0.05）。当前和长期哮喘控制之间的总体一致性有限（前一个季节为 66%，前一年为 68%）。
当前和长期哮喘控制之间的一致性有限。此外，我们还显示出显著的季节性差异。因此，重要的是计算较长时间的哮喘控制，而不是将当前的哮喘控制作为指标。
