Garpvall Kalle, Hauerslev Marie, Marckmann Mads, Hermansen Mette N, Hansen Kirsten S, Chawes Bo L
Department of Pediatric and Adolescent Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, 2730 Copenhagen, Denmark.
Allergy Clinic, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, 2820 Copenhagen, Denmark.
Children (Basel). 2021 Dec 16;8(12):1193. doi: 10.3390/children8121193.
Asthma is one of the most common chronic diseases in children globally. Previous studies have shown that not attending asthma primary care consultations is associated with poorer treatment adherence and increased risk of loss of asthma control on a short-term basis. Here, we investigated long-term patterns and predictors of not attending scheduled asthma outpatient visits during 5-years of follow-up in 146 children with asthma. Of the 146 children, 67 (46%) did not attend at least one scheduled appointment, amounting to a total of 122 (10.8%) missed of 1133 scheduled appointments. In a multivariate analysis adjusting for total scheduled visits in the 5-year period any allergic sensitization was a significant risk factor for not attending ≥1 scheduled appointment (aOR = 6.6 (95% CI, 1.3-39.7), = 0.03), which was not the case for asthma treatment step or lung function. Furthermore, atopic predisposition decreased the risk of non-attendance (aOR = 0.36 (0.13-0.92), = 0.04). We found no association between non-attendance, treatment adherence or loss of asthma control. This study highlights that allergic comorbidity, but not degree of asthma severity, identifies a group of children with asthma who are prone to not attend scheduled outpatient appointments.
哮喘是全球儿童中最常见的慢性病之一。先前的研究表明,不参加哮喘初级保健会诊与较差的治疗依从性相关,且短期内哮喘控制丧失的风险增加。在此,我们调查了146名哮喘儿童在5年随访期间未参加预定哮喘门诊就诊的长期模式及预测因素。在这146名儿童中,67名(46%)至少有一次未参加预定预约,在1133次预定预约中总计有122次(10.8%)未就诊。在对5年期间的总预定就诊次数进行校正的多变量分析中,任何过敏致敏都是未参加≥1次预定预约的显著危险因素(调整后比值比[aOR]=6.6(95%置信区间[CI],1.3 - 39.7),P = 0.03),而哮喘治疗步骤或肺功能则不然。此外,特应性易感性降低了未就诊的风险(aOR = 0.36(0.13 - 0.92),P = 0.04)。我们发现未就诊、治疗依从性或哮喘控制丧失之间无关联。本研究强调,过敏合并症而非哮喘严重程度,可识别出一组易不参加预定门诊预约的哮喘儿童。