Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Int J Clin Pharm. 2013 Apr;35(2):289-95. doi: 10.1007/s11096-012-9702-7. Epub 2013 Jan 29.
Asthma is one of the commonest causes of morbidity and mortality in childhood. The goals of the present study were to design a valid medication assessment tool for evaluating the quality of medication use according to recommendations of updated asthma guidelines for children aged from 5 to 12 years, and to quantify adherence to guideline recommendations.
Two primary care settings in Scotland, UK.
Recommendations related to the long-term management of asthmatic children in the British Thoracic Society/Scottish Intercollegiate Guidelines Network and Global Initiative for Asthma guidelines were identified and corresponding criteria were created. These criteria were incorporated to generate an assessment tool named MAT ASTHMA-PAED. Two phases of field-testing were undertaken and the tool was also subject to examination by a focus group of specialist practitioners. Thereafter, MAT ASTHMA-PAED was modified accordingly.
Applicability and adherence to each criterion and overall adherence to the MAT ASTHMA-PAED.
The MAT ASTHMA-PAED field-testing was undertaken in two primary care practices in Scotland, United Kingdom and 77 asthmatic children were recruited. Results of the pilot study field-testing showed a high overall adherence of 70.0 % (95 % CI: 58.7-81.3 %) to the guidelines. Low adherence (<50 %) was seen for 4 criteria, whereas 8 criteria were considered high-adherence criteria (>70 %). The final MAT ASTHMA-PAED comprised of 25 criteria was produced based on the results of field testing and the opinions from the focus group.
Although high utility of MAT ASTHMA-PAED criteria was found, there were gaps in the implementation of certain recommendations, particularly in relation to demonstrated satisfactory technique of inhaler. Moreover, further studies assessing the use of oral steroids and exercise-induced asthma, and wider implementation of MAT ASTHMA-PAED are required.
哮喘是儿童发病率和死亡率最高的常见原因之一。本研究的目的是设计一种有效的药物评估工具，根据更新的儿童哮喘指南建议评估药物使用质量，并量化对指南建议的依从性。
英国苏格兰的两个初级保健机构。
确定了英国胸科学会/苏格兰校际网络和全球哮喘倡议指南中与哮喘儿童长期管理相关的建议，并制定了相应的标准。将这些标准纳入其中，生成了一种名为 MAT ASTHMA-PAED 的评估工具。进行了两个阶段的现场测试，该工具还接受了一组专家从业者的焦点小组审查。此后，相应地修改了 MAT ASTHMA-PAED。
每个标准的适用性和依从性以及 MAT ASTHMA-PAED 的整体依从性。
MAT ASTHMA-PAED 的现场测试在英国苏格兰的两个初级保健机构进行，共招募了 77 名哮喘儿童。试点研究现场测试的结果表明，对指南的总体依从率很高，为 70.0%（95%可信区间：58.7-81.3%）。有 4 个标准的依从性较低（<50%），而 8 个标准被认为是高依从性标准（>70%）。根据现场测试结果和焦点小组的意见，最终的 MAT ASTHMA-PAED 包含 25 个标准。
尽管发现 MAT ASTHMA-PAED 标准的使用非常有用，但在某些建议的实施方面仍存在差距，特别是在展示令人满意的吸入器技术方面。此外，需要进一步研究评估口服类固醇和运动性哮喘的使用，并广泛实施 MAT ASTHMA-PAED。
