Woolcock Institute of Medical Research, University of Sydney, NSW, Australia.
Centre for Adolescent Health, Royal Children's Hospital, Melbourne, VIC, Australia.
Med J Aust. 2015 May 18;202(9):492-7. doi: 10.5694/mja14.01564.
To identify patterns of asthma control and treatment in Australian adults with asthma.
Cross-sectional web-based survey, conducted 1-27 November 2012.
Adults with current asthma, at least 16 years of age, drawn randomly from a web-based panel and weighted to reflect national population proportions for people with asthma.
Asthma Control Test (ACT) scores; health care utilisation; medication use.
2686 participants completed the survey (57.1% female; median age group, 40-49 years). Mean ACT score was 19.2 (95% CI, 18.9-19.3), with asthma classified as "well controlled" for 54.4% of participants, "not well controlled" for 22.7% and "very poorly controlled" for 23.0%. 60.8% reported using preventer medication (mostly combined inhaled corticosteroid/long-acting β2-agonist) during the previous year. 23.4% had made at least one urgent visit to a general practitioner concerning their asthma, 10.0% at least one emergency department visit. Urgent consultations were more common for "very poorly controlled" than "well controlled" asthma (adjusted odds ratio, urgent GP visits 5.98 [95% CI, 4.75-7.54] and emergency department visits 2.59 [95% CI, 1.91-3.53] respectively). Participants were classified according to asthma symptom control and frequency of preventer medication usage: Those with "well controlled" asthma included Group A (40.0% of participants) who used preventer medication infrequently (less than 5 days a week) or not at all, consistent with mild asthma, and Group B (14.7%), who used it at least 5 days a week. Uncontrolled asthma symptoms were reported by Group C (19.7%) despite regular preventer use, and by Group D (25.7%), who used none or little.
This study provides the first data about asthma control and its relationship with treatment in a large representative Australian population. The findings highlight significant preventable asthma morbidity in Australia.
确定澳大利亚成年哮喘患者的哮喘控制和治疗模式。
2012 年 11 月 1 日至 27 日进行的横断面网络调查。
从网络小组中随机抽取的当前患有哮喘、至少 16 岁的成年人,并对其进行加权处理,以反映全国哮喘人群的比例。
哮喘控制测试(ACT)评分;医疗保健利用;药物使用。
2686 名参与者完成了调查(57.1%为女性;中位年龄组为 40-49 岁)。平均 ACT 评分为 19.2(95%置信区间,18.9-19.3),54.4%的参与者哮喘被归类为“控制良好”,22.7%为“控制不佳”,23.0%为“控制极差”。60.8%的人在过去一年中使用了预防药物(大多为吸入性皮质类固醇/长效β2-激动剂联合用药)。23.4%的人因哮喘至少一次紧急就诊于全科医生,10.0%至少一次急诊就诊。与“控制良好”的哮喘相比,“控制极差”的哮喘更常见需要紧急就诊(调整后的优势比,紧急就诊全科医生 5.98[95%置信区间,4.75-7.54],紧急就诊急诊 2.59[95%置信区间,1.91-3.53])。参与者根据哮喘症状控制和预防药物使用频率进行分类:“控制良好”的哮喘患者包括 A 组(40.0%的参与者),他们很少(每周少于 5 天)或根本不使用预防药物,符合轻度哮喘的特点,以及 B 组(14.7%),他们每周至少使用 5 天。尽管经常使用预防药物,但仍有 C 组(19.7%)报告存在不可控制的哮喘症状,D 组(25.7%)报告根本不使用或很少使用。
本研究首次提供了澳大利亚大型代表性人群中哮喘控制及其与治疗关系的相关数据。研究结果突出了澳大利亚哮喘发病率显著且可预防。