Seinäjoki Health Care Centre, Seinäjoki, Finland.
Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
BMC Pulm Med. 2022 Feb 15;22(1):63. doi: 10.1186/s12890-022-01850-1.
Poor treatment compliance is a common problem in the treatment of asthma. To our knowledge, no previous long-term follow-up studies exist on how scheduled asthma follow-up contacts occur in primary health care (PHC) versus secondary care and how these contacts relate to adherence to medication and in participation to further scheduled asthma contacts. The aim of this study was to evaluate occurrence of scheduled asthma contacts and treatment compliance in PHC versus secondary care, and to identify the factors associated with non-participation to scheduled contacts.
Patients with new adult-onset asthma (n = 203) were followed for 12 years in a real-life asthma cohort of the Seinäjoki Adult Asthma Study (SAAS). The first contacts were mainly carried out in secondary care and therefore the actual follow-up time including PHC visits was 10 years.
A majority (71%) of the patients had ≥ 2 scheduled asthma contacts during 10-year follow-up and most of them (79%) mainly in PHC. Patients with follow-up contacts mainly in PHC had better adherence to inhaled corticosteroid (ICS) medication during the whole 12-year period compared to patients in secondary care. In the study population, 29% of the patients had only 0-1 scheduled asthma contacts during the follow-up. Heavy alcohol consumption predicted poor participation in scheduled contacts.
Patients with mainly PHC scheduled asthma contacts were more adherent to ICS medication than patients in the secondary care. Based on our results it is necessary to pay more attention to actualization of asthma follow-up visits and systematic assessment of asthma patients including evaluation of alcohol consumption. Trial registration Seinäjoki Adult Asthma Study is retrospectively registered at www.ClinicalTrials.gov with identifier number NCT02733016. Registered 11 April 2016.
治疗依从性差是哮喘治疗中的一个常见问题。据我们所知，以前没有关于初级保健（PHC）与二级保健中计划的哮喘随访接触如何发生以及这些接触与药物依从性和进一步计划的哮喘接触参与度的关系的长期随访研究。本研究旨在评估 PHC 与二级保健中计划的哮喘接触发生情况和治疗依从性，并确定与未参与计划接触相关的因素。
在真实生活中的西纳约基成人哮喘研究（SAAS）的哮喘队列中，对 203 例新诊断的成年哮喘患者进行了 12 年的随访。首次就诊主要在二级保健机构进行，因此实际随访时间包括 PHC 就诊时间为 10 年。
大多数患者（71%）在 10 年随访期间有≥2 次计划的哮喘接触，其中大多数（79%）主要在 PHC 进行。在整个 12 年期间，在 PHC 进行随访接触的患者对吸入皮质类固醇（ICS）药物的依从性更好。在研究人群中，29%的患者在随访期间仅有 0-1 次计划的哮喘接触。大量饮酒可预测计划接触参与度差。
与二级保健患者相比，主要在 PHC 进行计划的哮喘接触的患者对 ICS 药物的依从性更好。基于我们的结果，有必要更加关注哮喘随访的实际情况以及对哮喘患者的系统评估，包括对酒精摄入的评估。
西纳约基成人哮喘研究在 www.ClinicalTrials.gov 上进行了回顾性注册，注册号为 NCT02733016。于 2016 年 4 月 11 日注册。
