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在初级保健中实施哮喘控制测试以改善患者结局。

Implementation of the Asthma Control Test in Primary Care to Improve Patient Outcomes.

出版信息

J Pediatr Health Care. 2018 Nov-Dec;32(6):591-599. doi: 10.1016/j.pedhc.2018.05.004. Epub 2018 Aug 10.

Abstract

BACKGROUND

Asthma is one of the major chronic diseases in the pediatric population, affecting 9.5% of children. The National Heart, Lung, and Blood Institute recommends the use of the Asthma Control Test (ACT) for periodic assessment of asthma control. The purpose of this evidence-based project was to implement the Asthma Control Test screening tool into the primary care practice to improve management of patients with asthma by more accurately addressing asthma control.

METHODS

The project was a pre- and post-implementation study comparing two different groups of patients with asthma seen at the clinic over 5-week periods.

RESULTS

After the implementation of the educational program and project, 82.6% of advanced practice registered nurses and 30.7% of pediatric resident physicians used an Asthma Control Test, resulting in identification of 9 (21%) patients who were considered not well-controlled. All (100%) of those children identified as not well-controlled through the Asthma Control Test received an adjustment in their medication therapy.

CONCLUSIONS

The Childhood ACT and ACT are simple, self-administered, validated questionnaires that can easily be incorporated into a primary care practice to assess the level of asthma control and to identify patients with asthma that is not well controlled.

摘要

背景

哮喘是儿科人群中主要的慢性疾病之一,影响 9.5%的儿童。美国国家心肺血液研究所建议使用哮喘控制测试(ACT)定期评估哮喘控制情况。本循证项目的目的是将哮喘控制测试筛查工具纳入初级保健实践中,通过更准确地解决哮喘控制问题来改善哮喘患者的管理。

方法

该项目是一项在 5 周内比较诊所中两组不同哮喘患者的实施前和实施后的研究。

结果

在实施教育计划和项目后,82.6%的高级实践注册护士和 30.7%的儿科住院医师使用了哮喘控制测试,结果发现 9 名(21%)患者被认为控制不佳。通过哮喘控制测试确定为控制不佳的所有儿童(100%)都接受了药物治疗的调整。

结论

儿童哮喘控制测试和 ACT 是简单、自我管理、经过验证的问卷,可以很容易地纳入初级保健实践中,以评估哮喘控制水平,并确定哮喘控制不佳的患者。

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