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影响哮喘和慢性阻塞性肺疾病患者治疗方案选择及患者对所开处方治疗的依从性的因素。

Factors affecting the choice of therapeutic regimens in asthma and chronic obstructive pulmonary disease patients and patient adherence to the therapies prescribed.

作者信息

Nastałek Paweł, Kurek Adam, Almgren-Rachtan Agnieszka, Mastalerz-Migas Agnieszka, Doniec Zbigniew

机构信息

Pulmonology Clinic, Jagiellonian University Medical College, Krakow, Poland.

Department of General Surgery, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland.

出版信息

Postepy Dermatol Alergol. 2019 Apr;36(2):202-210. doi: 10.5114/ada.2018.76144. Epub 2018 Apr 3.

Abstract

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) and asthma are the most common chronic respiratory diseases worldwide. At the moment, there is no information about the preferences of Polish specialists as regards the treatment of asthma and COPD or factors influencing the choice of particular treatment regimens.

AIM

To determine the treatment options most commonly used by experienced pulmonologists and allergists for asthma and COPD and to identify the factors affecting the choice of a particular therapy.

MATERIAL AND METHODS

The survey included 224 doctors (pulmonologists and allergists) across Poland and concerned patients diagnosed with asthma ( = 4358) and COPD ( = 3062).

RESULTS

In the case of asthma, the most common therapy applied was inhaled glucocorticosteroids and long-acting β agonists. According to 27.2% of doctors, combination therapy was used in 70-80% of patients while 23.7% declared that the proportion of patients receiving such a treatment exceeded 80%. In the case of COPD, anticholinergics were most frequently prescribed when inhaled glucocorticosteroids and long-acting β agonists had proved insufficient. According to 21% of specialists, the percentage of patients treated so was 41-50%, while 19% declared the use of this treatment in 71-80% of patients.

CONCLUSIONS

The most common treatments for asthma and COPD in Poland are inhaled glucocorticosteroids and long-acting β agonists. The main factors influencing treatment decisions are the current GINA and GOLD recommendations as well as patients' age, comorbidities, and price of treatment.

摘要

引言

慢性阻塞性肺疾病(COPD)和哮喘是全球最常见的慢性呼吸道疾病。目前,尚无关于波兰专家在哮喘和COPD治疗方面的偏好或影响特定治疗方案选择因素的信息。

目的

确定经验丰富的肺科医生和过敏症专科医生治疗哮喘和COPD最常用的治疗方案,并确定影响特定治疗选择的因素。

材料与方法

该调查涵盖波兰各地的224名医生(肺科医生和过敏症专科医生),涉及被诊断为哮喘(=4358)和COPD(=3062)的患者。

结果

对于哮喘,最常用的治疗方法是吸入糖皮质激素和长效β受体激动剂。27.2%的医生表示,70 - 80%的患者采用联合治疗,而23.7%的医生称接受此类治疗的患者比例超过80%。对于COPD,当吸入糖皮质激素和长效β受体激动剂被证明效果不佳时,抗胆碱能药物是最常开具的处方。21%的专家表示,接受此类治疗的患者比例为41 - 50%,而19%的专家称71 - 80%的患者使用了这种治疗方法。

结论

波兰治疗哮喘和COPD最常用的方法是吸入糖皮质激素和长效β受体激动剂。影响治疗决策的主要因素是当前的全球哮喘防治创议(GINA)和慢性阻塞性肺疾病全球倡议(GOLD)建议以及患者的年龄、合并症和治疗费用价格。

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