Ayele Yohanes, Engidawork Ephrem, Bayisa Tola
Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Res Notes. 2017 Jul 25;10(1):314. doi: 10.1186/s13104-017-2645-2.
Inhaled corticosteroids (ICSs) are cornerstone therapy for persistent asthma. However, underutilization of ICSs is common and little is known about factors contributing toward this undesirable use.
A cross-sectional study was conducted through interview and chart review among persistent asthmatic patients attending chest clinic of Tikur Anbessa Specialized Hospital from 1 May to 31 September 2014. A total of 131 eligible patients who attended the clinic during study period were included in the study. A multivariate logistic regression was used to examine the association between independent and dependent variables.
Overall, extent of underutilization of ICSs was found to be 68%. Monthly income, comorbidity and types of ICSs products prescribed showed significant association with reported underutilization. Patients' reported reasons for underutilization includes; unaffordability (44%), using only when symptoms exacerbate (21%), fear of side effects (10%), practitioners' recommendation (10%) and unavailability of ICSs in the local market (7%). Physicians also stated unaffordability, fear of side effects and dependency, lack of local guideline for asthma management and unavailability of ICSs as the contributing factors.
In this setting, extent of underutilization of ICSs was found to be high and seems the result of complex interaction of various factors. Financial problem combined with inconsistent availability of ICSs in the local market, patients' poor knowledge of asthma and ICSs, negative attitude toward ICSs, absence of local guidelines for asthma management are found to be essential elements dictating an extent of ICSs use.
吸入性糖皮质激素（ICSs）是持续性哮喘的基础治疗药物。然而，ICSs的使用不足情况很常见，对于导致这种不理想使用情况的因素知之甚少。
2014年5月1日至9月31日，通过访谈和病历审查，对在提库尔·安贝萨专科医院胸部诊所就诊的持续性哮喘患者进行了一项横断面研究。共有131名在研究期间到该诊所就诊的符合条件的患者被纳入研究。采用多因素逻辑回归分析来检验自变量和因变量之间的关联。
总体而言，发现ICSs的使用不足率为68%。月收入、合并症和所开ICSs产品类型与报告的使用不足情况显示出显著关联。患者报告的使用不足原因包括：负担不起（44%）、仅在症状加重时使用（21%）、害怕副作用（10%）、医生建议（10%）以及当地市场上ICSs缺货（7%）。医生也指出负担不起、害怕副作用和依赖性、缺乏哮喘管理的当地指南以及ICSs缺货是促成因素。
在这种情况下，发现ICSs的使用不足程度很高，似乎是多种因素复杂相互作用的结果。经济问题、当地市场上ICSs供应不一致、患者对哮喘和ICSs的了解不足、对ICSs的消极态度以及缺乏哮喘管理的当地指南被认为是决定ICSs使用程度的关键因素。
