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ARGA 研究与全科医生:医学教育对哮喘/鼻炎管理的影响。

The ARGA study with general practitioners: impact of medical education on asthma/rhinitis management.

机构信息

Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste, 41 - 56126 Pisa, Italy.

出版信息

Respir Med. 2012 Jun;106(6):777-85. doi: 10.1016/j.rmed.2012.02.013. Epub 2012 Mar 20.

Abstract

AIM

To evaluate the impact of a medical education course (MEC) on the behaviour of general practitioners (GPs) to treat asthma and allergic rhinitis (AR).

METHODS

Data on 1820 patients (mean age 41 yrs ± 17 yrs) with asthma or AR were collected by 107 Italian GPs: 50% attended a MEC and 50% didn't (group B). The adherence for AR and asthma treatment was evaluated according to ARIA and GINA guidelines (GL).

RESULTS

AR and asthma were diagnosed in 78% and 56% of patients; 34% had concomitant AR and asthma. Regardless of the MEC, the adherence to GL was significantly higher for AR than for asthma treatment (52 versus 19%). Group B GPs were more compliant to ARIA guidelines in the treatment of mild AR, whereas group A were more compliant in the treatment of moderate-severe AR; the adherence didn't differ between the groups for AR patients with comorbid asthma. Adherence to GINA GL for asthma treatment did not differ between GPs of groups A and B, independently from concomitant AR. Though insignificantly, group A were more compliant to GINA GL in the treatment of patients with only severe persistent asthma (63 versus 46%) as group B were for patients with severe persistent asthma and concomitant AR.

CONCLUSIONS

GPs often tend to treat patients independently from GL. The impact of a single MEC did not improve adherence to GL in treating less severe AR and asthma patients, while there was a trend towards the opposite attitude in more severe AR patients without concomitant asthma.

摘要

目的

评估医学教育课程(MEC)对全科医生(GP)治疗哮喘和过敏性鼻炎(AR)行为的影响。

方法

107 名意大利全科医生收集了 1820 名哮喘或 AR 患者(平均年龄 41 岁±17 岁)的数据:50%参加了 MEC,50%未参加(B 组)。根据 ARIA 和 GINA 指南(GL)评估 AR 和哮喘治疗的依从性。

结果

78%的患者诊断为 AR,56%的患者诊断为哮喘;34%的患者同时患有 AR 和哮喘。无论是否参加 MEC,AR 的治疗依从性均明显高于哮喘(52%比 19%)。B 组 GP 在轻度 AR 的治疗中更符合 ARIA 指南,而 A 组在中度-重度 AR 的治疗中更符合 ARIA 指南;对于同时患有哮喘的 AR 患者,两组之间的依从性没有差异。A、B 两组 GP 治疗哮喘的 GINA GL 依从性无差异,与是否同时患有 AR 无关。尽管不显著,但 A 组在仅患有严重持续性哮喘(63%比 46%)的患者中更符合 GINA GL,而 B 组在严重持续性哮喘和同时患有 AR 的患者中更符合 GINA GL。

结论

GP 通常倾向于根据 GL 独立治疗患者。单次 MEC 并没有改善治疗轻度 AR 和哮喘患者的 GL 依从性,而在没有同时患有哮喘的更严重 AR 患者中,这种态度有改善的趋势。

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