Janson Christer, Accordini Simone, Cazzoletti Lucia, Cerveri Isa, Chanoine Sebastien, Corsico Angelo, Ferreira Diogenes Seraphim, Garcia-Aymerich Judith, Gislason David, Nielsen Rune, Johannessen Ane, Jogi Rain, Malinovschi Andrei, Martinez-Moratalla Rovira Jesús, Marcon Alessandro, Pin Isabelle, Quint Jennifer, Siroux Valerie, Almar Enrique, Bellisario Valeria, Franklin Karl A, Gullón José A, Holm Mathias, Heinrich Joachim, Nowak Dennis, Sánchez-Ramos José Luis, Weyler Joost J, Jarvis Deborah
Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden.
Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK.
ERJ Open Res. 2019 Feb 1;5(1). doi: 10.1183/23120541.00073-2018. eCollection 2019 Feb.
Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma.
尽管药物治疗已发生了很大变化，但哮喘常常仍未得到有效控制。我们研究了20年间哮喘治疗的变化情况，并确定了与规律使用吸入性糖皮质激素（ICS）治疗相关的因素。在4617名随机选取的受试者中确定了用药情况的变化，同时对369名持续性哮喘成人患者的情况变化进行了分析。该研究比较了11个国家24个中心三项调查的数据。在普通人群中，ICS的使用从1.7%增至5.9%，在持续性哮喘患者中，ICS的规律使用从19%增至34%。报告在过去12个月内有哮喘发作的哮喘患者比例下降，而在过去12个月内看过医生的患者比例保持不变（42%）。经历过发作或看过医生的哮喘患者更有可能规律使用ICS。尽管ICS的使用有所增加，但只有三分之一的持续性哮喘患者规律使用ICS。不到一半的患者在过去一年看过医生。这表明，在哮喘管理中，ICS使用不足以及缺乏定期医疗接触仍是一个问题。
