Haahtela Tari, Valovirta Erkka, Saarinen Kimmo, Jantunen Juha, Lindström Irmeli, Kauppi Paula, Laatikainen Tiina, Pelkonen Anna, Salava Alexander, Tommila Erja, Bousquet Jean, Vasankari Tuula, Mäkelä Mika J
Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland; Allergy Clinic, Suomen Terveystalo Oy, Turku, Finland.
J Allergy Clin Immunol. 2021 Aug;148(2):319-326.e4. doi: 10.1016/j.jaci.2021.03.037. Epub 2021 May 5.
A 10-year national program to improve prevention and management of allergic diseases and asthma was implemented in Finland (population 5.5. million) in 2008-2018. The main aim was to reduce the long-term burden of these conditions. The strategy was changed from traditional avoidance to tolerance and resilience of the population. Health was endorsed instead of medicalization of mild symptoms. Disease severity was reevaluated, and disabling clinical manifestations were given high priority. For health care, 5 quantitative goals and 1 qualitative goal were set. For each of the goals, specific tasks, tools, and outcome evaluation were stipulated. During the program, 376 educational sessions gathered 24,000 health care participants. An information campaign targeted the lay public, and social media was used to contact people. In the 10 years of the program, the prevalence of allergic diseases and asthma leveled off. Asthma caused fewer symptoms and less disability, and 50% fewer hospital days. Food allergy diets in day care and schools decreased by half. Occupational allergies were reduced by 45%. In 2018, the direct and indirect costs of allergic diseases and asthma ranged from €1.5 billion to €1.8 billion, with the 2018 figures being 30% less than in the respective figures in 2007. The Finnish proactive and real-world intervention markedly reduced the public health burden of allergic disorders. The allergy paradigm was revisited to improve management with systematic education.
2008年至2018年，芬兰（人口550万）实施了一项为期10年的全国性计划，以改善过敏性疾病和哮喘的预防与管理。其主要目标是减轻这些疾病的长期负担。策略从传统的回避转变为增强人群的耐受性和恢复力。倡导关注健康而非将轻微症状医学化。重新评估了疾病严重程度，并将致残的临床表现列为高度优先事项。针对医疗保健设定了5个定量目标和1个定性目标。针对每个目标，规定了具体任务、工具和结果评估。在该计划期间，376场教育课程吸引了24000名医疗保健参与者。开展了针对普通大众的宣传活动，并利用社交媒体与人们取得联系。在该计划实施的10年里，过敏性疾病和哮喘的患病率趋于平稳。哮喘引起的症状减少，致残情况减轻，住院天数减少了50%。日托机构和学校中食物过敏饮食减少了一半。职业性过敏减少了45%。2018年，过敏性疾病和哮喘的直接和间接成本在15亿至18亿欧元之间，2018年的数据比2007年的相应数据减少了30%。芬兰积极主动的现实干预显著减轻了过敏性疾病的公共卫生负担。通过系统教育重新审视了过敏模式，以改善管理。
