Harrison Philippa, Duggan William, Preddy John, Moline Adrienne
Rural Clinical School, UNSW Medicine, New South Wales, Australia.
Department of Paediatrics, Wagga Wagga Rural Referral Hospital, Wagga Wagga, New South Wales, Australia.
J Paediatr Child Health. 2020 Feb;56(2):194-200. doi: 10.1111/jpc.14553. Epub 2019 Jun 26.
This study aimed to explore the relationship between indicators of socio-economic status (SES) and prescription of a paediatric individualised asthma action plan (IAAP), as well as compliance with that plan.
Between May and September 2017, parents/carers of children aged 2-16 years who presented with acute respiratory symptoms and a prior diagnosis of asthma to the emergency department at one regional and one metropolitan hospital in NSW, Australia, were invited to participate in a questionnaire-based study.
A total of 175 eligible participants were identified, of which 113 completed the questionnaire. Eighty-seven children had been prescribed an IAAP (77%). Forty-nine parents/carers reported non-compliance with that plan (56.3%). Children from low- to middle-income families were significantly less likely to have a plan (P = 0.001). Being an only child was associated with greater IAAP compliance (P = 0.007) and better asthma control (P = 0.035). No significant relationship between other indicators of SES and rates of plan ownership or compliance was demonstrated.
Although relatively high in our study sample, IAAP ownership rates remain well below published guidelines. Given the income-based disparity in plan ownership, physicians must routinely prescribe plans to all asthmatics. Strategies to ensure IAAP ownership and promote their use, especially in the public health sector, would be valuable. Repeating a similar study with a larger sample size will allow more robust conclusions to be drawn regarding the impact of parental SES on compliance.
本研究旨在探讨社会经济地位(SES)指标与儿科个体化哮喘行动计划(IAAP)的处方之间的关系,以及对该计划的依从性。
2017年5月至9月期间,邀请澳大利亚新南威尔士州一家地区医院和一家都市医院急诊科中出现急性呼吸道症状且先前被诊断为哮喘的2至16岁儿童的父母/照顾者参加一项基于问卷的研究。
共确定了175名符合条件的参与者,其中113人完成了问卷。87名儿童被开具了IAAP(77%)。49名父母/照顾者报告未遵守该计划(56.3%)。低收入至中等收入家庭的儿童拥有计划的可能性显著降低(P = 0.001)。独生子女与更高的IAAP依从性(P = 0.007)和更好的哮喘控制(P = 0.035)相关。SES的其他指标与计划拥有率或依从率之间未显示出显著关系。
尽管在我们的研究样本中IAAP拥有率相对较高,但仍远低于已发布的指南。鉴于计划拥有率存在基于收入的差异,医生必须常规为所有哮喘患者开具计划。确保IAAP拥有并促进其使用的策略,尤其是在公共卫生部门,将很有价值。用更大的样本量重复类似研究将有助于就父母SES对依从性的影响得出更可靠的结论。