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与少数族裔青少年哮喘患者吸入皮质类固醇依从性水平相关的因素。

Factors associated with levels of adherence to inhaled corticosteroids in minority adolescents with asthma.

机构信息

Department of Preventive Medicine, Rush Medical College, Chicago, Illinois.

Department of Preventive Medicine, Rush Medical College, Chicago, Illinois.

出版信息

Ann Allergy Asthma Immunol. 2014 Feb;112(2):116-20. doi: 10.1016/j.anai.2013.11.021. Epub 2013 Dec 21.

Abstract

BACKGROUND

Nonadherence to inhaled corticosteroids (ICS) is a significant risk factor for poor asthma outcomes in minority adolescents with persistent asthma.

OBJECTIVE

To identify factors associated with nonadherence to daily ICS in this target population.

METHODS

Adolescents 11 to 16 years old, self-identified as African American or Hispanic, diagnosed with persistent asthma and with an active prescription for daily ICS were invited to participate. Participant adherence to ICS was electronically measured during 14 days. Concurrently, participants completed the following assessments: demographic information, asthma history, asthma control, asthma exacerbations, media use, depression, asthma knowledge, ICS knowledge, and ICS self-efficacy. Of the 93 subjects, 68 had low (<48%) adherence and 25 had high (>48%) adherence.

RESULTS

Older age and low ICS knowledge each were associated with low (≤48%) adherence (P < .01 for the 2 variables).

CONCLUSION

Older age and low ICS knowledge each may be associated with poor adherence to ICS in minority adolescents with persistent asthma. Although older age often is associated with the assignment of increased responsibility for medication-taking behavior, it may not be associated with increased adherence. Continued and expanded efforts at promoting asthma education and specifically knowledge of ICS may increase adherence to ICS.

摘要

背景

在持续性哮喘的少数族裔青少年中,不遵医嘱使用吸入性皮质类固醇(ICS)是导致不良哮喘结局的一个重要危险因素。

目的

确定与该目标人群中每日 ICS 不依从相关的因素。

方法

邀请年龄在 11 至 16 岁之间、自我认定为非裔美国人和西班牙裔、被诊断为持续性哮喘且正在使用每日 ICS 处方的青少年参与。在 14 天内,通过电子方式测量参与者对 ICS 的依从性。同时,参与者完成了以下评估:人口统计学信息、哮喘史、哮喘控制、哮喘加重、媒体使用、抑郁、哮喘知识、ICS 知识和 ICS 自我效能。在 93 名受试者中,有 68 名依从性低(<48%),25 名依从性高(>48%)。

结果

年龄较大和 ICS 知识较低均与低(≤48%)依从性相关(两个变量均 P<.01)。

结论

年龄较大和 ICS 知识较低可能与持续性哮喘的少数族裔青少年不遵医嘱使用 ICS 有关。尽管年龄较大通常与药物治疗行为的责任增加有关,但它可能与依从性的增加无关。持续和扩大促进哮喘教育,特别是 ICS 知识的努力可能会增加 ICS 的依从性。

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