Department of Primary Care, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
CEO Office, Education for Health, Warwick, UK.
J Allergy Clin Immunol Pract. 2018 May-Jun;6(3):962-971. doi: 10.1016/j.jaip.2017.10.007. Epub 2017 Nov 20.
Asthma is a highly heterogeneous disease that can be classified into different clinical phenotypes, and treatment may be tailored accordingly. However, factors beyond purely clinical traits, such as patient attitudes and behaviors, can also have a marked impact on treatment outcomes.
The objective of this study was to further analyze data from the REcognise Asthma and LInk to Symptoms and Experience (REALISE) Europe survey, to identify distinct patient groups sharing common attitudes toward asthma and its management.
Factor analysis of respondent data (N = 7,930) from the REALISE Europe survey consolidated the 34 attitudinal variables provided by the study population into a set of 8 summary factors. Cluster analyses were used to identify patient clusters that showed similar attitudes and behaviors toward each of the 8 summary factors.
Five distinct patient clusters were identified and named according to the key characteristics comprising that cluster: "Confident and self-managing," "Confident and accepting of their asthma," "Confident but dependent on others," "Concerned but confident in their health care professional (HCP)," and "Not confident in themselves or their HCP." Clusters showed clear variability in attributes such as degree of confidence in managing their asthma, use of reliever and preventer medication, and level of asthma control.
The 5 patient clusters identified in this analysis displayed distinctly different personal attitudes that would require different approaches in the consultation room certainly for asthma but probably also for other chronic diseases.
哮喘是一种高度异质性的疾病,可以分为不同的临床表型,治疗方法也可以据此进行调整。然而,除了纯粹的临床特征之外,患者的态度和行为等因素也会对治疗结果产生显著影响。
本研究旨在进一步分析 REcognise Asthma and LInk to Symptoms and Experience(REALISE)欧洲调查的数据,以确定具有共同哮喘管理态度的不同患者群体。
对 REALISE 欧洲调查中(N=7930)受访者数据进行因子分析,将研究人群提供的 34 个态度变量整合为 8 个综合因子。使用聚类分析来确定在每个综合因子上表现出相似态度和行为的患者群体。
共确定了 5 个不同的患者群体,并根据构成该群体的关键特征进行命名:“自信和自我管理型”“自信并接受哮喘”“自信但依赖他人”“关心但对医疗保健提供者有信心”和“对自己或医疗保健提供者缺乏信心”。这些聚类在管理哮喘的自信程度、缓解和预防药物的使用以及哮喘控制水平等属性方面表现出明显的差异。
本分析中确定的 5 个患者聚类表现出明显不同的个人态度,这在咨询室中肯定需要不同的方法,不仅适用于哮喘,也可能适用于其他慢性疾病。