Grover Charu, Armour Carol, Asperen Peter Paul Van, Moles Rebekah, Saini Bandana
Faculty of Pharmacy, University of Sydney, Camperdown Campus, Sydney, New South Wales, Australia.
J Asthma. 2011 Dec;48(10):1085-103. doi: 10.3109/02770903.2011.624234. Epub 2011 Oct 21.
The global burden of pediatric asthma is high. Governments and health-care systems are affected by the increasing costs of childhood asthma--in terms of direct health-care costs and indirect costs due to loss of parental productivity, missed school days, and hospitalizations. Despite the availability of effective treatment, the current use of medications in children with asthma is suboptimal. The purpose of this review is to scope the empirical literature to identify the problems associated with the use of pediatric asthma medications. The findings will help to design interventions aiming to improve the use of asthma medications among children.
A literature search using electronic search engines (i.e., Medline, International Pharmaceutical Abstracts (IPA), PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) and the search terms "asthma," "children," and "medicines" (and derivatives of these keywords) was conducted.
The search terms were expanded to include emergent themes arising out of search findings. Content themes relating to parents, children themselves, health-care professionals, organizational systems, and specific medications and devices were found. Within these themes, key issues included a lack of parental knowledge about asthma and asthma medications, lack of information provided to parents, parental beliefs and fears, parental behavioral problems, the high costs of medications and devices, the child's self-image, the need for more child responsibility, physician nonadherence to prescribing guidelines, "off-label" prescribing, poor understanding of teachers, lack of access to educational resources, and specific medications.
These key issues should be taken into account when modifying the development of educational tools. These tools should focus on targeting the children themselves, the parent/carers, the health-care professionals, and various organizational systems.
小儿哮喘的全球负担沉重。政府和医疗保健系统受到儿童哮喘成本不断增加的影响，这些成本包括直接医疗保健成本以及因父母生产力损失、缺课天数和住院导致的间接成本。尽管有有效的治疗方法，但目前哮喘患儿的药物使用情况并不理想。本综述的目的是梳理实证文献，以确定与小儿哮喘药物使用相关的问题。研究结果将有助于设计旨在改善儿童哮喘药物使用情况的干预措施。
使用电子搜索引擎（即医学索引数据库（Medline）、国际药学文摘数据库（IPA）、医学期刊数据库（PubMed）、心理学文摘数据库（PsycINFO）以及护理及相关健康文献累积索引数据库（CINAHL）），并使用搜索词“哮喘”“儿童”和“药物”（以及这些关键词的衍生词）进行文献检索。
搜索词被扩展，以纳入搜索结果中出现的新主题。发现了与父母、儿童自身、医疗保健专业人员、组织系统以及特定药物和设备相关的内容主题。在这些主题中，关键问题包括父母对哮喘和哮喘药物缺乏了解、向父母提供的信息不足、父母的信念和恐惧、父母的行为问题、药物和设备成本高昂、儿童的自我形象、需要儿童承担更多责任、医生未遵循处方指南、“超说明书”用药、教师理解不足、缺乏教育资源获取途径以及特定药物。
在修改教育工具的开发时应考虑这些关键问题。这些工具应侧重于针对儿童自身、父母/照顾者、医疗保健专业人员以及各种组织系统。
