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妥布霉素吸入粉剂治疗慢性铜绿假单胞菌感染囊性纤维化患者的治疗依从性:FREE 研究。

Treatment compliance in cystic fibrosis patients with chronic Pseudomonas aeruginosa infection treated with tobramycin inhalation powder: The FREE study.

机构信息

Department of Pathophysiology and Transplantation, University of Milan, Cardio-thoracic Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.

Dipartimento di Scienze Mediche Traslazionali, Centro Regionale Fibrosi Cistica, Sezione Adulti, Università di Napoli Federico II, Naples, Italy.

出版信息

Respir Med. 2018 May;138:88-94. doi: 10.1016/j.rmed.2018.03.034. Epub 2018 Mar 31.

Abstract

BACKGROUND

A high treatment burden with nebulised therapies in cystic fibrosis (CF) patients is the major limitation for treatment compliance; moreover, studies on treatment compliance with inhaled antibiotics are limited. This study assessed compliance to TOBI Podhaler™ (TIP) treatment in CF patients with chronic Pseudomonas aeruginosa (Pa) infections in a real-world setting using the Italian Treatment Adherence CF Questionnaire (ITA-CFq).

METHODS

This longitudinal, multicentre, cohort study included 2 follow-up (FU) visits: FU-1 at 3-months±15-days from the baseline visit and FU-2 at the end of third TIP cycle (or 6-months after enrolment, whichever occurred first). The effect of TIP on quality-of-life (QoL) and treatment satisfaction were evaluated using Cystic Fibrosis Questionnaire-Revised (CFQ-R) and Treatment Satisfaction Questionnaire for Medication (TSQM), respectively. Overall compliance to treatments was assessed using ITA-CFq.

RESULTS

Eighty-two patients (mean age, 24.8 ± 7.9 years), including 22 paediatric patients (age, <18 years), were enrolled in the study; 56 (68.3%) patients, including 17 paediatric patients, completed the study. At baseline, the mean compliance score to aerosol antibiotic treatment was 7.8 ± 3.2; upon introducing TIP, the compliance score improved to 9.4 ± 1.2 at the FU-1 and thereafter remained stable at 9.5 ± 1.2. TSQM was higher for the convenience domain (74.2 ± 17.1 at enrolment and slightly improved to 77.8 ± 15.9 at FU-2) following TIP initiation. No substantial effect of TIP was observed on the QoL when measured using the revised CFQ-R. The safety profile was in line with previous findings.

CONCLUSION

TIP was convenient to use and led to improved treatment adherence in CF patients with chronic Pa-infection.

摘要

背景

囊性纤维化(CF)患者使用雾化疗法的治疗负担高是治疗依从性的主要限制;此外,关于吸入抗生素治疗依从性的研究有限。本研究使用意大利 CF 治疗依从性问卷(ITA-CFq)评估了在真实环境中,慢性铜绿假单胞菌(Pa)感染的 CF 患者对 TOBI Podhaler(TIP)治疗的依从性。

方法

这是一项纵向、多中心、队列研究,包括 2 次随访(FU):从基线访视开始的 3 个月±15 天进行 FU-1,以及第三个 TIP 周期结束时(或入组后 6 个月,以先发生者为准)进行 FU-2。使用 CF 问卷修订版(CFQ-R)和药物治疗满意度问卷(TSQM)分别评估 TIP 对生活质量(QoL)和治疗满意度的影响。使用 ITA-CFq 评估总体治疗依从性。

结果

该研究共纳入 82 例患者(平均年龄 24.8±7.9 岁),包括 22 例儿科患者(年龄<18 岁);56 例(68.3%)患者,包括 17 例儿科患者,完成了研究。基线时,抗生素雾化治疗的平均依从性评分为 7.8±3.2;引入 TIP 后,FU-1 时的依从性评分提高至 9.4±1.2,此后保持稳定在 9.5±1.2。自 TIP 开始后,TSQM 的便利性域评分较高(入组时为 74.2±17.1,略有提高至 FU-2 时的 77.8±15.9)。使用修订后的 CFQ-R 测量时,TIP 对 QoL 没有明显影响。安全性概况与先前的发现一致。

结论

TIP 使用方便,可提高慢性 Pa 感染 CF 患者的治疗依从性。

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