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基层医疗中过敏性鼻炎治疗不足的特征及预测因素

Characteristics and predictors of allergic rhinitis undertreatment in primary care.

作者信息

Spinozzi F, Murgia N, Baldacci S, Maio S, Pala A P, Casciari C, dell'Omo M, Viegi G

机构信息

Laboratory of Experimental Immunology and Allergy, Department of Medicine, University of Perugia, Piazzale Gambuli, 06100 Perugia, Italy.

Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Piazzale Gambuli, 06100 Perugia, Italy

出版信息

Int J Immunopathol Pharmacol. 2016 Mar;29(1):129-36. doi: 10.1177/0394632015595779. Epub 2015 Dec 17.

Abstract

Although allergic rhinitis is considered a raising medical problem in many countries it is often undertreated. The reasons for this phenomenon are not completely clear.The aim of this study is to evaluate factors associated with allergic rhinitis under-/no treatment.A sample of 518 allergic rhinitis patients recruited by their primary care physicians, as a part of the ARGA study, were invited to fill in a specific questionnaire regarding rhinitis symptoms, treatment, and rhinitis-related work/social disability. Chi-square test and logistic regression were performed to assess risk factors for allergic rhinitis under-/no treatment.Over one out of four patients had no treatment despite the symptoms and 13.5% were inadequately treated. Participants with asthma (OR 0.47, 95% CI 0.30-0.75) and conjunctivitis (0.44, 95% CI 0.27-0.71) were at lower risk of allergic rhinitis under-/no treatment: in asthmatics this reduction was related mainly to the concomitant asthma treatment (OR 0.19, 95% CI 0.10-0.37).Asthmatics with under-/not treated rhinitis had the highest prevalence of rhinitis-related quality of life impairment.Under-/no treatment for allergic rhinitis is still rather frequent despite the relevance of this disease. The simultaneous presence of asthma and an anti-asthmatic therapy are able to influence positively the treatment. Targeted interventions toward a better characterization and a tight follow-up of rhinitis patient without asthma are needed.

摘要

尽管变应性鼻炎在许多国家被视为一个日益严重的医学问题,但它常常治疗不足。这种现象的原因尚不完全清楚。本研究的目的是评估与变应性鼻炎未治疗/未充分治疗相关的因素。作为ARGA研究的一部分,由初级保健医生招募的518名变应性鼻炎患者样本被邀请填写一份关于鼻炎症状、治疗以及与鼻炎相关的工作/社会残疾的特定问卷。采用卡方检验和逻辑回归来评估变应性鼻炎未治疗/未充分治疗的危险因素。超过四分之一的患者尽管有症状但未接受治疗,13.5%的患者治疗不充分。患有哮喘(比值比[OR]0.47,95%可信区间[CI]0.30 - 0.75)和结膜炎(OR 0.44,95% CI 0.27 - 0.71)的参与者变应性鼻炎未治疗/未充分治疗的风险较低:在哮喘患者中,这种降低主要与同时进行的哮喘治疗有关(OR 0.19,95% CI 0.10 - 0.37)。鼻炎未治疗/未充分治疗的哮喘患者鼻炎相关生活质量受损的患病率最高。尽管变应性鼻炎具有相关性,但未治疗/未充分治疗的情况仍然相当常见。哮喘的同时存在和抗哮喘治疗能够对治疗产生积极影响。需要针对没有哮喘的鼻炎患者进行更精准的特征描述和密切随访的有针对性干预措施。

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Characteristics and predictors of allergic rhinitis undertreatment in primary care.基层医疗中过敏性鼻炎治疗不足的特征及预测因素
Int J Immunopathol Pharmacol. 2016 Mar;29(1):129-36. doi: 10.1177/0394632015595779. Epub 2015 Dec 17.

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