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青少年哮喘未控制持续期吸入治疗知识和管理责任

Knowledge of Inhaled Therapy and Responsibility for Asthma Management Among Young Teens With Uncontrolled Persistent Asthma.

机构信息

University of Rochester School of Medicine and Dentistry, Rochester, NY.

University of Rochester School of Medicine and Dentistry, Rochester, NY.

出版信息

Acad Pediatr. 2018 Apr;18(3):317-323. doi: 10.1016/j.acap.2018.01.006. Epub 2018 Jan 31.

Abstract

OBJECTIVES

To compare the abilities of teens with uncontrolled persistent asthma and their caregivers to identify inhaled medications and state correct indications for use; examine medication responsibility within dyads; and determine whether responsibility is associated with knowledge about inhaled therapies.

METHODS

In the baseline survey for the School-Based Asthma Care for Teens (SB-ACT) trial, we separately asked caregivers and teens to: 1) identify the teen's inhaled asthma therapies by name and from a picture chart (complete matches considered "concordant"); 2) describe indications of use for each medication; and 3) describe the allocation of responsibility for medication use within dyads. We limited analyses to dyads in which either member reported at least one rescue and one inhaled controller medication; we used McNemar and Pearson chi-square tests.

RESULTS

A total of 136 dyads were analyzed. More caregivers than teens concordantly identified medications (63% vs 31%, P < .001). There was no difference between caregivers and teens in the ability to state correct indications for use (56% vs 54%, P = .79). More teens than caregivers endorsed "full teen responsibility" for rescue medication (65% vs 27%, P < .001) and controller medication use (50% vs 15%, P < .001). Neither concordant identification nor knowing indications for use was associated with reported medication responsibility.

CONCLUSIONS

Medication responsibility within dyads of caregivers and teens with persistent asthma is not associated with knowledge about inhaled therapies. Targeting both members of the dyad with education and self-management strategies before responsibility transitions start may allow providers to avoid a missed opportunity to support these emerging stakeholders to adherence.

摘要

目的

比较未控制的持续性哮喘青少年及其照顾者识别吸入药物并陈述正确使用适应证的能力;检查双元体中的药物责任;并确定责任是否与吸入疗法知识相关。

方法

在基于学校的青少年哮喘护理(SB-ACT)试验的基线调查中,我们分别要求照顾者和青少年:1)通过名称和图片图表识别青少年的吸入哮喘疗法(完全匹配被认为是“一致”);2)描述每种药物的使用适应证;3)描述双元体中药物使用责任的分配。我们将分析仅限于报告至少一种急救药物和一种吸入控制器药物的双元体;我们使用 McNemar 和 Pearson 卡方检验。

结果

共分析了 136 对双元体。更多的照顾者比青少年一致识别药物(63%比 31%,P<0.001)。照顾者和青少年在正确陈述使用适应证的能力方面没有差异(56%比 54%,P=0.79)。更多的青少年比照顾者认可急救药物(65%比 27%,P<0.001)和控制器药物使用(50%比 15%,P<0.001)的“完全青少年责任”。一致识别和了解适应证与报告的药物责任无关。

结论

持续性哮喘青少年双元体中的药物责任与吸入疗法知识无关。在责任过渡开始之前,针对双元体的两个成员进行教育和自我管理策略,可能使提供者能够避免错失支持这些新兴利益相关者坚持治疗的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f8/5903444/81934e1a2cfd/nihms956443f1.jpg

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