Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
Medical Research Institute of New Zealand, Wellington, New Zealand.
Respir Med. 2020 Dec;175:106154. doi: 10.1016/j.rmed.2020.106154. Epub 2020 Sep 13.
Combination low-dose budesonide-formoterol, taken as-needed for symptom relief reduces exacerbation risk and is recommended for treatment of mild asthma. The NovelQ qualitative study explored patients' attitudes toward using this novel therapy.
Adults with mild asthma using reliever-only treatment were randomised to as-needed budesonide-formoterol Turbuhaler® in a multinational, 52-week open-label randomised controlled trial (NovelSTART-ACTRN12615000999538). A subgroup were interviewed to explore their attitudes to use of as-needed budesonide-formoterol after receiving it for ≥10 months. Semi-structured interviews were conducted until saturation, audio-recorded, and thematically analysed.
Analysis of 35 participants (66% female; mean age 43.5 [range 18-74]; mean Asthma Control Questionnaire score 1.09 ± SD0.55) interviews identified 5 themes, each including both barriers and facilitators to therapy use. Themes were: 'Treatment effectiveness' i.e. how well symptoms were relieved and/or prevented; 'Lifestyle fit of the regimen' e.g. the extent to which the treatment regimen integrated into the patient's daily life; 'Attitudes toward medication use and safety' e.g. openness for new reliever treatments, beliefs about treatment necessity or side effects; 'Device attributes' e.g. perceived ease of use; and 'Doctor-patient relationship' e.g. impact of health professional support on new treatment acceptance.
A wide range of factors seem to drive the opinions of mild asthma patients on as-needed budesonide-formoterol therapy. Many patients perceived both positive and negative treatment attributes, and their individual evaluation of these attributes determined their likelihood of using it after the study. Supportive patient-physician interactions appear key to addressing patient barriers. Recommendations for patient-centred discussions, developed from this research, are provided.
按需使用低剂量布地奈德-福莫特罗进行症状缓解可降低加重风险，推荐用于轻度哮喘的治疗。NovelQ 定性研究探索了患者对使用这种新型治疗方法的态度。
使用仅缓解药物治疗的轻度哮喘成年患者被随机分配到按需使用布地奈德-福莫特罗 Turbuhaler®的多国、52 周开放性随机对照试验（NovelSTART-ACTRN12615000999538）中。对一部分患者进行了访谈，以探讨他们在接受按需使用布地奈德-福莫特罗治疗至少 10 个月后的使用态度。进行了半结构化访谈，直到达到饱和，进行音频记录，并进行主题分析。
对 35 名参与者（66%为女性；平均年龄 43.5 [范围 18-74]；平均哮喘控制问卷得分为 1.09±0.55）的访谈进行分析，确定了 5 个主题，每个主题都包括治疗使用的障碍和促进因素。这些主题包括：“治疗效果”，即症状缓解和/或预防的程度；“治疗方案的生活方式适应性”，例如治疗方案在多大程度上融入了患者的日常生活；“对药物使用和安全性的态度”，例如对新的缓解治疗的开放性、对治疗必要性或副作用的信念；“设备属性”，例如使用的便利性；以及“医患关系”，例如卫生专业人员支持对新治疗接受度的影响。
许多因素似乎影响了轻度哮喘患者对按需使用布地奈德-福莫特罗治疗的看法。许多患者对治疗的属性有积极和消极的看法，他们对这些属性的个人评价决定了他们在研究结束后使用它的可能性。支持性的医患互动似乎是解决患者障碍的关键。从这项研究中提出了一些针对以患者为中心的讨论的建议。
