亚洲国家儿童哮喘的监测和管理：问卷调查研究。

Monitoring and management of childhood asthma in asian countries: a questionnaire study.

机构信息

From the Department of Paediatrics, The Children's Medical Institute, National University Singapore, Singapore.

出版信息

World Allergy Organ J. 2009 Jan;2(1):3-8. doi: 10.1097/WOX.0b013e318194c0f6.

DOI:10.1097/WOX.0b013e318194c0f6

PMID:23282887

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3651034/

Abstract

BACKGROUND

: A recent study by the International Study of Asthma and Allergies in Childhood has shown that asthma symptom prevalence is still increasing in parts of Asia. As such, it is important to know how well asthma is being managed. Practices of physicians in India, China, Sri Lanka, Australia, Singapore, Indonesia, Philippines, and Taiwan in monitoring and treating childhood asthma were examined.

METHODS

: A 6-page standardized questionnaire was sent to physicians via post. The questionnaire is made up of 3 parts, including (1) methods of monitoring of childhood asthma, (2) practices in managing acute asthma exacerbations, and (3) choice of therapy in maintenance treatment.

RESULTS

: Our study reflects mostly the practices of physicians who practice in urban regions. Of respondents, 41.4% were general pediatricians, whereas 26.3% were general practitioners. A small fraction of physicians used score cards or diaries to monitor asthma, ranging from 0% (Philippines and Australia) to 15.9% (India). Only 8.1% (Sri Lanka) to 52.0% (Australia) use either a peak flow meter and/or spirometry to monitor asthma. However, for frequency of use, 35% (China) to 94% (Indonesia) never or seldom make use of a peak flow meter, and 33% (China) to 97.6% (Indonesia) never or seldom use spirometry for monitoring. Most physicians treat acute asthma appropriately with short-acting bronchodilators. For maintenance treatment, an inhaled corticosteroid was the most frequently chosen first-choice therapy. However, a significant fraction of physicians chose a long-acting β-agonist monotherapy as a first-choice treatment for asthma maintenance. For infants, the percentage ranged from 1.4% (Australia) to 76.3% (Indonesia); in preschoolers, 1.8% (Australia) to 43.3% (Indonesia); and in older children, 0% (Philippines) to 28.8% (Indonesia). These results may be related to the overall affluence of each nation.

CONCLUSIONS

: There is much room for improvement in increasing physicians' awareness to guidelines for more effective management of pediatric asthma in Southeast Asia, especially regarding the high use of long-acting β-agonist monotherapy, even in young children.

摘要

背景

国际儿童哮喘和过敏研究最近的一项研究表明，亚洲部分地区的哮喘症状患病率仍在上升。因此，了解哮喘的管理情况非常重要。本研究旨在调查印度、中国、斯里兰卡、澳大利亚、新加坡、印度尼西亚、菲律宾和中国台湾的医生在监测和治疗儿童哮喘方面的做法。

方法

通过邮寄向医生发送了一份 6 页的标准化问卷。问卷由 3 部分组成，包括（1）监测儿童哮喘的方法，（2）管理急性哮喘加重的方法，（3）维持治疗中治疗选择。

结果

我们的研究反映了大多数在城市地区行医的医生的做法。在回答者中，41.4%是儿科全科医生，而 26.3%是全科医生。只有 0%（菲律宾和澳大利亚）至 15.9%（印度）的医生使用评分卡或日记监测哮喘。仅 8.1%（斯里兰卡）至 52.0%（澳大利亚）使用峰流速仪和/或肺量计监测哮喘。然而，在使用频率方面，35%（中国）至 94%（印度尼西亚）从不或很少使用峰流速仪，33%（中国）至 97.6%（印度尼西亚）从不或很少使用肺量计监测哮喘。大多数医生使用短效支气管扩张剂适当治疗急性哮喘。对于维持治疗，吸入皮质类固醇是最常选择的一线治疗药物。然而，相当一部分医生选择长效β-激动剂单药治疗作为哮喘维持的首选治疗。对于婴儿，百分比范围从 1.4%（澳大利亚）至 76.3%（印度尼西亚）；在学龄前儿童中，1.8%（澳大利亚）至 43.3%（印度尼西亚）；在年龄较大的儿童中，0%（菲律宾）至 28.8%（印度尼西亚）。这些结果可能与每个国家的总体富裕程度有关。