Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Allergol Int. 2020 Jan;69(1):61-65. doi: 10.1016/j.alit.2019.07.006. Epub 2019 Aug 13.
Adherence Starts with Knowledge-12 (ASK-12) is a useful indicator of drug adherence. In this study, we analyzed patient background including social and psychological factors in a low-adherence group of patients with asthma defined using ASK-12.
From a questionnaire survey for patients with asthma from the Niigata Prefecture, Japan, conducted in the fall of 2016, we enrolled patients who answered all ASK-12 items and underwent a measured respiratory function test within 1 year. The low-adherence group (ASK-12 ≥ 28) was compared with the control group (ASK-12 < 28), and we conducted a cluster analysis of the low-adherence group.
There were 170 patients in the low-adherence group and 402 patients in the control group. There was a significant difference between age, gender, working status, smoking history, the percentage of forced expiratory volume in one second (%FEV), asthma control test (ACT), and Patient Health Questionnaire-9 (PHQ-9) score between the two groups. Logistic analysis revealed that working status (working), % FEV (<90%), and PHQ-9 score (>5) were independent factors for the low-adherence group. The cluster analysis identified three clusters in the low-adherence group. Among these, one cluster was characterized by elderly males with chronic obstructive pulmonary disease and another by middle-aged nonsmoking females with a depression tendency, had problems with asthma control.
Several factors were considered to be attributed to low drug-adherence. There were several phenotypes in the low-adherence population correlated with incomplete asthma control. Intervention with drug adherence should be a future goal for asthma treatment.
Adherence Starts with Knowledge-12（ASK-12）是一种评估药物依从性的有用指标。在这项研究中，我们分析了哮喘低依从组患者的背景，包括社会和心理因素，这些患者是根据 ASK-12 定义的。
我们从日本新潟县的哮喘患者问卷调查中招募了所有 ASK-12 项目都回答了且在 1 年内接受过肺功能测量测试的患者。将低依从组（ASK-12≥28）与对照组（ASK-12<28）进行比较，并对低依从组进行聚类分析。
低依从组有 170 例患者，对照组有 402 例患者。两组在年龄、性别、工作状态、吸烟史、一秒用力呼气容积占预计值的百分比（%FEV）、哮喘控制测试（ACT）和患者健康问卷-9（PHQ-9）评分方面存在显著差异。Logistic 分析显示，工作状态（工作）、%FEV（<90%）和 PHQ-9 评分（>5）是低依从组的独立因素。聚类分析在低依从组中识别出三个聚类。其中，一个聚类的特征是患有慢性阻塞性肺疾病的老年男性，另一个聚类的特征是有抑郁倾向、控制哮喘有问题的中年非吸烟女性。
认为有几个因素导致药物低依从性。低依从人群中存在与不完全哮喘控制相关的几种表型。提高药物依从性应成为哮喘治疗的未来目标。
