Department of Child Health, Division of Applied Health Sciences School of Medicine, University of Aberdeen, Aberdeen, United Kingdom.
PLoS One. 2012;7(6):e39130. doi: 10.1371/journal.pone.0039130. Epub 2012 Jun 27.
The role of asthma controller medication adherence and the level of asthma control in children is poorly defined.
To assess the association between asthma controller medication adherence and asthma control in children using routinely acquired prescribing data.
A retrospective observational study of children aged 0-18 years prescribed inhaled corticosteroids only (ICS), leukotriene receptors antagonists (LTRA), or long-acting β2 agonists (LABA) and ICS prescribed as separate or combined inhalers, between 01/09/2001 and 31/08/2006, registered with primary care practices contributing to the Practice Team Information database. The medication possession ratio (MPR) was calculated and associations with asthma control explored. Poor asthma control was defined as the issue of prescriptions for ≥ 1 course of oral corticosteroids (OCS) and/or ≥ 6 short-acting β2 agonists (SABA) canisters annually.
A total of 3172 children prescribed asthma controller medication were identified. Of these, 15-39% (depending on controller medication) demonstrated adequate MPR. Adequate MPR was associated with male gender, good socio-economic status, and oral LTRA therapy. Adequate MPR was more likely to be associated with increased use of rescue medication. However logistic regression only identified a significant relationship for ICS only (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.35-2.48; p<0.001), LTRA (OR, 2.11; 95% CI, 1.27-3.48; p = 0.004) and LABA/ICS (OR, 2.85; 95% CI, 1.62-5.02; p<0.001).
Poor adherence was observed for all asthma controller medications, although was significantly better for oral LRTA. In this study adequate adherence was not associated with the use of less rescue medication, suggesting that adherence is a complex issue.
哮喘控制药物的依从性和哮喘控制水平在儿童中的作用尚未明确。
使用常规获得的处方数据评估儿童哮喘控制药物依从性与哮喘控制之间的关系。
对 2001 年 9 月 1 日至 2006 年 8 月 31 日期间在初级保健机构注册、使用吸入皮质激素（ICS）、白三烯受体拮抗剂（LTRA）或长效β2 激动剂（LABA）和 ICS 单独或联合吸入器的 0-18 岁儿童进行回顾性观察性研究。计算药物持有率（MPR）并探讨其与哮喘控制的关系。哮喘控制不佳定义为每年开具≥1 次口服皮质激素（OCS）和/或≥6 次短效β2 激动剂（SABA）罐的处方。
共确定了 3172 名接受哮喘控制药物治疗的儿童。其中，15-39%（取决于控制药物）的患者 MPR 充足。适当的 MPR 与男性性别、良好的社会经济地位和口服 LTRA 治疗相关。适当的 MPR 更可能与更多使用急救药物相关。然而，逻辑回归仅确定 ICS 单药治疗（比值比[OR]，1.89；95%置信区间[CI]，1.35-2.48；p<0.001）、LTRA（OR，2.11；95% CI，1.27-3.48；p=0.004）和 LABA/ICS（OR，2.85；95% CI，1.62-5.02；p<0.001）与 MPR 显著相关。
所有哮喘控制药物的依从性均较差，尽管口服 LTRA 的依从性明显更好。在这项研究中，适当的依从性与使用较少的急救药物无关，这表明依从性是一个复杂的问题。
