每月一次自我报告的ACT问卷在哮喘门诊患者吸入器治疗依从性管理中的应用
Application of Once-Monthly Self-Reported ACT Questionnaire in Management of Adherence to Inhalers in Outpatients with Asthma.
作者信息
Zhang Jing, Yin Chengchen, Li Hongfang, Wei Weipeng, Gong Yuansha, Tang Fushan
机构信息
Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi 563006, People's Republic of China.
Department of Respiratory Medicine, Central Hospital in Jinchang City (Worker's Hospital of Jinchuan Group), Jinchang 737102, People's Republic of China.
出版信息
Patient Prefer Adherence. 2020 Jun 19;14:1027-1036. doi: 10.2147/PPA.S176683. eCollection 2020.
PURPOSE
Poor medication adherence can negatively affect health outcomes of patients with asthma from medication and significantly increase the healthcare costs. Management of adherence to inhalers remains a challenging topic in the long-term management of patients with asthma. We aim to evaluate the role of asthma control test (ACT) in the management of adherence to inhalers in outpatients with asthma.
PATIENTS AND METHODS
Six hundred twenty-seven outpatients with asthma admitted to the clinic of respiratory medicine in a tertiary hospital in northwestern China during 2016 to 2019 were randomly divided into observation group (n= 315) and control (n= 312) and received standard inhalant therapy for 6 months and lung function test before and after treatment. The patients in the observation group took ACT questionnaires at the end of each month, while the patients in control only took an ACT at the end of the last month. The 'Test of Adherence to Inhalers' (TAI) questionnaire was used to evaluate the patients' adherence to inhalant therapy.
RESULTS
All patients completed the study. The ACT scores in the observation group showed a gradual increase month by month. The TAI results indicated that adherence to inhalers of patients in the observation group was significantly better than that in control and the patients' non-adherence pattern in the observation group, with significantly lower erratic non-adherence, was also different from that in control. After 6 months of treatment, the lung function indexes and their relative improvement and the ACT scores in the observation group were significantly better or higher than those in control.
CONCLUSION
The once-monthly self-reported ACT can effectively improve the adherence to inhalers of outpatients with asthma mainly by addressing erratic non-adherence and improve the treatment effects, and thus deserves widespread use in the treatment adherence management in patients with asthma.
目的
用药依从性差会对哮喘患者的药物治疗健康结局产生负面影响，并显著增加医疗成本。在哮喘患者的长期管理中，吸入器使用依从性的管理仍是一个具有挑战性的话题。我们旨在评估哮喘控制测试（ACT）在哮喘门诊患者吸入器使用依从性管理中的作用。
患者与方法
2016年至2019年期间在中国西北部一家三级医院呼吸内科就诊的627例哮喘门诊患者被随机分为观察组（n = 315）和对照组（n = 312），接受标准吸入治疗6个月，并在治疗前后进行肺功能测试。观察组患者在每个月末填写ACT问卷，而对照组患者仅在最后一个月末填写ACT问卷。采用“吸入器使用依从性测试”（TAI）问卷评估患者对吸入治疗的依从性。
结果
所有患者均完成研究。观察组的ACT评分逐月逐渐升高。TAI结果表明，观察组患者对吸入器的依从性明显优于对照组，且观察组患者的不依从模式与对照组不同，不稳定不依从显著更低。治疗6个月后，观察组的肺功能指标及其相对改善情况以及ACT评分均显著优于或高于对照组。
结论
每月一次的自我报告ACT主要通过解决不稳定不依从问题，可有效提高哮喘门诊患者对吸入器的依从性，并改善治疗效果，因此值得在哮喘患者的治疗依从性管理中广泛应用。
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