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支气管哮喘患者使用全身性皮质类固醇:一项真实世界研究。

Systemic Corticosteroids in Patients With Bronchial Asthma: A Real-Life Study.

作者信息

Izquierdo J L, Almonacid C, Campos C, Morena D, Benavent M, González-de-Olano D, Rodríguez J M

机构信息

Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain.

Respiratory Medicine, University Hospital of Guadalajara, Guadalajara, Spai.

出版信息

J Investig Allergol Clin Immunol. 2024 Oct 1;33(1):30-38. doi: 10.18176/jiaci.0765. Epub 2021 Apr 15.

Abstract

OBJECTIVE

The objective of the present study was to determine the use of systemic corticosteroids (SCs) in patients with bronchial asthma using big data analysis.

METHODS

We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was performed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using big data and artificial intelligence via Savana® Manager version 3.0.

RESULTS

During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels. The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. SCs were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, obesity, depression, and hiatus hernia. SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%), and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects.

CONCLUSION

In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events. It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care.

摘要

目的

本研究的目的是通过大数据分析确定支气管哮喘患者全身用糖皮质激素(SCs)的使用情况。

方法

我们基于从电子健康记录中的自由文本捕获的二次数据进行了一项观察性、回顾性、非干预性研究。本研究基于西班牙卡斯蒂利亚-拉曼恰地区卫生服务机构(SESCAM)的数据进行。我们通过Savana® Manager 3.0版本使用大数据和人工智能进行分析。

结果

在研究期间,103667名患者在不同护理级别被诊断为哮喘并接受治疗。搜索限于年龄在10至90岁(平均年龄43.5[95%CI,43.4 - 43.7]岁)的患者。其中,59.8%为女性。在研究期间的某个时间点,58745名患者使用SCs治疗哮喘。这些患者年龄较大,高血压、血脂异常、糖尿病、肥胖、抑郁症和食管裂孔疝的患病率较高。SCs在哮喘普通人群中使用频繁(2015年为31.4%,2019年为39.6%)。SCs主要在初级保健(59%)、过敏科(13%)和肺病科(20%)开具处方。SCs的处方频率对主要相关不良反应有直接影响。

结论

在临床实践中,SCs经常被开给哮喘患者,尤其是在初级保健中。使用SCs与更多不良事件相关。有必要采取措施减少向哮喘患者开具SCs的处方,尤其是在初级保健中。

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