Abramson Michael J, Schattner Rosa L, Holton Christine, Simpson Pam, Briggs Nancy, Beilby Justin, Nelson Mark R, Wood-Baker Richard, Thien Francis, Sulaiman Nabil D, Colle Eleonora Del, Wolfe Rory, Crockett Alan J, Massie R John
Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic, Australia.
Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
Pediatr Pulmonol. 2015 Oct;50(10):947-54. doi: 10.1002/ppul.23096. Epub 2014 Sep 8.
To determine whether spirometry and regular medical review improved quality of life or other outcomes in children and adolescents with asthma.
We conducted two cluster randomized controlled trials. We recruited 238 asthma patients aged between 7 and 17 years from 56 general practices in South Eastern Australia. Participants were randomized to receive an intervention that included spirometry or usual care. The main outcome measure was asthma related quality of life.
Baseline characteristics were well matched between the intervention and control groups. Neither trial found any difference in asthma related quality of life between groups. However because of measurement properties, a formal meta-analysis could not be performed. Nor were there any significant effects of the intervention upon asthma attacks, limitation to usual activities, nocturnal cough, bother during physical activity, worry about asthma, or written asthma action plans.
The findings do not support more widespread use of spirometry for the management of childhood asthma in general practice, unless it is integrated into a complete management model.
确定肺功能测定和定期医学检查是否能改善哮喘儿童和青少年的生活质量或其他结局。
我们进行了两项整群随机对照试验。我们从澳大利亚东南部56家普通诊所招募了238名年龄在7至17岁之间的哮喘患者。参与者被随机分配接受包括肺功能测定的干预措施或常规护理。主要结局指标是哮喘相关生活质量。
干预组和对照组的基线特征匹配良好。两项试验均未发现两组之间在哮喘相关生活质量上有任何差异。然而，由于测量特性，无法进行正式的荟萃分析。干预措施对哮喘发作、日常活动受限、夜间咳嗽、体育活动时的困扰、对哮喘的担忧或书面哮喘行动计划也没有任何显著影响。
研究结果不支持在普通医疗中更广泛地使用肺功能测定来管理儿童哮喘，除非将其纳入完整的管理模式。
