The George Washington University School of Medicine, Director, Pulmonary, Critical Care and Respiratory Services, Washington Hospital Center, 110 Irving St., NW, Washington, DC 20010, USA.
Expert Rev Respir Med. 2013 Jun;7(3):307-20. doi: 10.1586/ers.13.27.
There are three major problems with asthma care in the USA and misuse of asthma drug therapy contributes to each. Asthma patients suffer from symptoms regularly partly because healthcare providers do not understand the Expert Panel Report III (EPR3) recommendations on assessing asthma symptoms to determine drug treatment and, consequently, undertreat the disease. Asthma patients experience exacerbations often in part because the EPR3 provides limited guidance on using exacerbation risk to guide asthma treatment, again leading to undertreatment. The EPR3 recommends inhaled corticosteroids as the preferred therapy for mild persistent asthma but American healthcare providers disregard this recommendation based on different perceptions about the risks and benefits of inhaled corticosteroids and choose drug treatments with higher healthcare costs.
美国的哮喘护理存在三个主要问题，而哮喘药物治疗的误用则是造成这三个问题的原因。哮喘患者经常出现症状，部分原因是医疗保健提供者不了解评估哮喘症状以确定药物治疗的专家小组报告 III（EPR3）建议，因此对疾病的治疗不足。哮喘患者经常经历恶化，部分原因是 EPR3 提供的关于使用恶化风险来指导哮喘治疗的指导有限，再次导致治疗不足。EPR3 建议将吸入皮质类固醇作为轻度持续哮喘的首选治疗方法，但美国医疗保健提供者无视这一建议，这是基于对吸入皮质类固醇的风险和益处的不同看法，并选择具有更高医疗成本的药物治疗。
