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埃塞俄比亚阿达马阿达马医院医学院哮喘患者吸入性糖皮质激素使用不足的影响因素

Contributing Factors for Underutilization of Inhaled Corticosteroids Among Asthmatic Patients Attending at Adama Hospital Medical College, Adama, Ethiopia.

作者信息

Tadesse Sileshi, Beyene Zinash

机构信息

Department of Pharmacology, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.

Department of Pharmacy, Rift Valley University, Adama Campus, Adama, Ethiopia.

出版信息

J Asthma Allergy. 2020 Sep 11;13:333-341. doi: 10.2147/JAA.S264119. eCollection 2020.

Abstract

INTRODUCTION

Inhaled corticosteroids (ICSs) are a cornerstone medicine for preventive therapy of persistent severe asthma. Although ICs are very effective for the treatment of severe persistent asthma, the majority of the prescribers worldwide aren't aware of ICs use for the treatment of severe persistent asthma.

OBJECTIVE

To evaluate factors contributing to underutilization of ICS by asthmatic patients.

METHODS

Patient interview was conducted among asthmatic patients using a cross-sectional study design who were attending at the Adama Hospital Medical College from March 1 to July 25, 2017. The total number of patients involved in the study was 94. Semi-structured questionnaire through patient interview was used for data collection and data from physicians who were working at the chest clinic of AHMC were collected by self-administered semi-structured questionnaire focusing their perspectives and experiences on patients' ICS.

RESULTS

Generally 73.5% of underutilization of ICS was reported from the total number of patients involved in the study according to the patient's perception. Monthly income, comorbid disease, and behaviors of ICS use were the main factors contributing to underutilization of ICS. According to patient's report, some of the reasons for underutilization of ICS were unaffordability, using the drugs only when symptoms appear, inaccessibility, side effects and recommendation by physicians. There were also similar reports by the physicians working in the AHMC.

CONCLUSION

In our study setting, prevalence of underutilization of ICS was high and the contributing factors were increased cost of ICS, inaccessibility of ICS, poor knowledge of the patients on asthma disease and ICS, bad attitude toward ICS, and lack of recently reviewed local guideline for asthma treatment. Thus, concerned experts need to take actions that guarantee accessibility of ICS at a reasonable price and increase awareness of patients about asthma disease and use of ICS.

摘要

引言

吸入性糖皮质激素(ICS)是持续性重度哮喘预防性治疗的基础药物。尽管ICS对重度持续性哮喘的治疗非常有效,但全球大多数开处方者并不了解ICS可用于治疗重度持续性哮喘。

目的

评估导致哮喘患者未充分使用ICS的因素。

方法

采用横断面研究设计,于2017年3月1日至7月25日对在阿达马医院医学院就诊的哮喘患者进行患者访谈。参与研究的患者总数为94名。通过患者访谈使用半结构化问卷收集数据,并通过自填式半结构化问卷收集在AHMC胸部诊所工作的医生的数据,重点关注他们对患者使用ICS的看法和经验。

结果

根据患者的认知,在参与研究的患者总数中,总体报告有73.5%的患者未充分使用ICS。月收入、合并疾病和ICS使用行为是导致未充分使用ICS的主要因素。根据患者报告,未充分使用ICS的一些原因包括负担不起、仅在症状出现时使用药物、难以获得、副作用以及医生的建议。在AHMC工作的医生也有类似报告。

结论

在我们的研究环境中,ICS未充分使用的患病率很高,促成因素包括ICS成本增加、难以获得ICS、患者对哮喘疾病和ICS的知识匮乏、对ICS的不良态度以及缺乏近期修订的哮喘治疗本地指南。因此,相关专家需要采取行动,确保以合理价格获得ICS,并提高患者对哮喘疾病和ICS使用的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6169/7494382/fe1f747a6ac8/JAA-13-333-g0001.jpg

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