Ma Qianli, Luo Guangming, Zhou Xiangdong, Huang Ying, Liu Enmei, Hong Xin, Mao Liangping, Wu Yamei, Chen Xumei, Liao Xiuqing, Qin Guangmei, Wang Daoxin, Li Lian, Zhang Shifu, Wang Changzheng
Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Department of Respiratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing, China.
Clin Respir J. 2018 Jan;12(1):262-268. doi: 10.1111/crj.12525. Epub 2016 Jul 27.
Treatment non-adherence is a challenge to achieve asthma control. However, few prospective studies were done for exploring asthma patient adherence in real world.
To evaluate treatment adherence and causes of non-adherence in a large asthma Chinese population. To analyze newly-diagnosed patients' adherence first time.
About 1582 asthma patients' data were collected from 12 study centers in China from February, 2012 to October, 2012. Disease and treatment information of subjects were collected were at first clinic visit, at 4, 12, and 24 weeks after that, follow-up phone calls were carried out for recording subjects' treatment adherence based on their self-reports. Subjects who reported non-adherence were additionally asked to choose the primary non-adherence cause from a list of nine potential causes.
Treatment adherence rate of all subjects markedly decreased from 83.3% at week 4 to 42.0% at week 24 after the first clinic visit. Significantly, at week 24, good treatment adherence rate in newly-diagnosed patients was lower than those patients with asthma history (22.9% vs. 63.9%, P < .001). Newly-diagnosed patients were three times more likely to become non-adherence than those patients with asthma history. Female patients had lower treatment adherence rate than male patients (38.3% vs. 45.6%, P = .006). Subjects in 30-39 year age group had the worst treatment adherence (27.3%). The most commonly chosen cause for non-adherence was "relief of symptoms after short-term controller medication use" (43.8%).
Asthma patients' treatment adherence could be improved by improving patient education, doctor/patient partnership, and level of medical service in Chinese population.
治疗依从性是实现哮喘控制的一项挑战。然而，在现实世界中，很少有前瞻性研究探索哮喘患者的依从性。
评估中国大量哮喘患者群体的治疗依从性及不依从的原因。分析新诊断患者首次的依从性情况。
2012年2月至2012年10月期间，从中国12个研究中心收集了约1582例哮喘患者的数据。在首次就诊时收集受试者的疾病和治疗信息，之后在第4、12和24周进行随访电话，根据受试者的自我报告记录其治疗依从性。对于报告不依从的受试者，还要求他们从九种潜在原因列表中选择主要的不依从原因。
首次就诊后，所有受试者的治疗依从率从第4周的83.3%显著下降至第24周的42.0%。值得注意的是，在第24周时，新诊断患者的良好治疗依从率低于有哮喘病史的患者（22.9%对63.9%，P＜0.001）。新诊断患者不依从的可能性是有哮喘病史患者的三倍。女性患者的治疗依从率低于男性患者（38.3%对45.6%，P = 0.006）。30 - 39岁年龄组的受试者治疗依从性最差（27.3%）。最常选择的不依从原因是“短期使用控制药物后症状缓解”（43.8%）。
通过改善中国人群的患者教育、医患关系和医疗服务水平，可以提高哮喘患者的治疗依从性。
