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成年哮喘患者吸入器的依从性及相关因素:孟加拉国拉杰沙希一家三级医院的门诊研究

Adherence to inhalers and associated factors among adult asthma patients: an outpatient-based study in a tertiary hospital of Rajshahi, Bangladesh.

作者信息

Rafi Md Abdur, Tahmin Chowdhury Ibtida, Tashrik Symom, Bonna Atia Sharmin, Jannat Ferdousy, Mily Sabrina Jahan, Shrestha Abhigan Babu, Seemanta Senjuti, Rashid Afsana, Mahjabeen Mosarrat, Nura Nurunnahar, Shahriar Tasnim, Mahadi Ashrafur Rahaman, Ahmed Kawser, Hasan Mohammad Jahid, Haque Md Azizul, Hossain Md Golam

机构信息

Rajshahi Medical College, Rajshahi, Bangladesh.

Pi Research Consultancy Center, Dhaka, Bangladesh.

出版信息

Asthma Res Pract. 2022 Feb 9;8(1):1. doi: 10.1186/s40733-022-00083-7.

Abstract

BACKGROUND

Adherence to inhaler medication is an important contributor to optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence levels and to identify the potential factors associated with non-adherence to the inhalers among asthma patients.

METHODS

This facility-based cross-sectional study was conducted in the medicine outpatient department of Rajshahi Medical College Hospital from November 2020 to January 2021. A total of 357 clinically confirmed adult asthma patients were interviewed. Inhaler adherence was measured using the 10-item Test of Adherence scale (TAI).. Both descriptive and inferential statistics were used to express the socio-demographic of the patients and predictors of poor adherence to inhaler.

RESULTS

A substantial number of participants were non-adherent (86%) to inhaler medication. Patients non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67-146.08), lived in the rural area (23.28, 95% CI 2.43-222.66), less year of schooling (5.69, 95% CI 1.27-25.44), and belonged to the middle income (aOR 9.74, 95% CI 2.11-44.9) than those adherent with the inhaler. The presence of comorbidities (12.91, 95% CI 1.41-117.61), prolonged duration of inhaler intake (5.69, 95% CI 1.22-26.49), consulting non-qualified practitioners (13.09, 95% CI 3.10-55.26) were the significant contributor of non-adherence.

CONCLUSION

Despite ongoing motivation and treatment, non-adherence to inhalation anti-asthmatic is high and several factors have been found to contribute. Regular monitoring and a guided patient-centered self-management approach might be helpful to address them in long run.

摘要

背景

与适当的药物治疗一样,坚持使用吸入器药物是实现最佳哮喘控制的重要因素。本研究的目的是评估自我报告的依从性水平,并确定哮喘患者中与不坚持使用吸入器相关的潜在因素。

方法

这项基于机构的横断面研究于2020年11月至2021年1月在拉杰沙希医学院医院的内科门诊部进行。共采访了357名临床确诊的成年哮喘患者。使用10项依从性测试量表(TAI)测量吸入器依从性。描述性和推断性统计均用于表达患者的社会人口统计学特征以及吸入器依从性差的预测因素。

结果

相当多的参与者(86%)不坚持使用吸入器药物。不坚持使用吸入器药物的患者通常更年轻(23.15,95%置信区间3.67 - 146.08),居住在农村地区(23.28,95%置信区间2.43 - 222.66),受教育年限较少(5.69,95%置信区间1.27 - 25.44),且与坚持使用吸入器的患者相比属于中等收入(调整后比值比9.74,95%置信区间2.11 - 44.9)。合并症的存在(12.91,95%置信区间1.41 - 117.61)、吸入器使用时间延长(5.69,95%置信区间1.22 - 26.49)、咨询不合格的从业者(13.09,95%置信区间3.10 - 55.26)是不依从的重要因素。

结论

尽管持续进行了激励和治疗,但吸入性抗哮喘药物的不依从率仍然很高,并且发现有几个因素导致了这种情况。定期监测和以患者为中心的指导式自我管理方法可能有助于从长远角度解决这些问题。

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