Darmon David, Laforest Laurent, Van Ganse Eric, Petrazzuoli Ferdinando, van Weel Chris, Letrilliart Laurent
Département d'enseignement et de recherche en médecine générale, Faculté de médecine, Université de Nice Sophia-Antipolis, 28 avenue Valombrose, 06 107, Nice, Cedex 02, France.
Unité de Pharmaco épidémiologie, Faculté d'Odontologie, UMR 5558 CNRS - Université Claude-Bernard Lyon, CHU, Lyon, France.
BMC Fam Pract. 2015 Feb 6;16:14. doi: 10.1186/s12875-015-0222-0.
Asthma is often poorly controlled and guidelines are often inadequately followed in medical practice. In particular, the prescription of non-asthma-specific drugs can affect the quality of care. The goal of this study was to measure the frequency of the prescription of antibiotics and anxiolytics/hypnotics to asthmatic patients and to look for associations between sex or age and the prescription of these drugs.
A cross-sectional study was conducted using computerised medical records from French and Italian general practitioners' networks. Patients were selected according to criteria adapted from the HEDIS (Healthcare Effectiveness Data and Information Set) criteria. The outcome measure was the number of antibiotics or anxiolytics/hypnotics prescriptions per patient in 1 year. Parallel multivariate models were developed.
The final sample included 3,093 French patients (mean age 27.6 years, 49.7% women) and 3,872 Italian patients (mean age 29.1 years, 48.7% women). In the univariate analysis, the French patients were prescribed fewer antibiotics than the Italian patients (37.1% vs. 42.2%, p < 0.00001) but more anxiolytics/hypnotics (17.8% vs. 6.9%, p < 0.0001). In the multivariate models, the female patients were more likely to receive antibiotics (odds ratio: 1.5 [1.3-1.7]) and anxiolytics/hypnotics (odds ratio: 1.8 [1.5-2.1]).
The prescription of antibiotics and anxiolytics/hypnotics to asthmatic patients is frequent, especially in women. Asthma guidelines should address this issue by referring to other guidelines covering the prescription of non-asthma-specific drugs, and alternative non-pharmacological interventions should be considered.
哮喘在医疗实践中常常控制不佳，且指南常常未得到充分遵循。特别是，非哮喘特异性药物的处方会影响医疗质量。本研究的目的是测量哮喘患者抗生素和抗焦虑药/催眠药的处方频率，并寻找性别或年龄与这些药物处方之间的关联。
使用来自法国和意大利全科医生网络的计算机化医疗记录进行了一项横断面研究。根据从HEDIS（医疗保健效果数据和信息集）标准改编的标准选择患者。结局指标是每位患者1年内抗生素或抗焦虑药/催眠药的处方数量。建立了平行多变量模型。
最终样本包括3093名法国患者（平均年龄27.6岁，49.7%为女性）和3872名意大利患者（平均年龄29.1岁，48.7%为女性）。在单变量分析中，法国患者的抗生素处方比意大利患者少（37.1%对42.2%，p<0.00001），但抗焦虑药/催眠药处方更多（17.8%对6.9%，p<0.0001）。在多变量模型中，女性患者更有可能接受抗生素（优势比：1.5[1.3-1.7]）和抗焦虑药/催眠药（优势比：1.8[1.5-2.1]）。
哮喘患者抗生素和抗焦虑药/催眠药的处方很常见，尤其是在女性中。哮喘指南应通过参考其他涵盖非哮喘特异性药物处方的指南来解决这一问题，并应考虑替代性非药物干预措施。
