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埃塞俄比亚亚的斯亚贝巴成年哮喘患者的哮喘治疗结果及与哮喘控制不佳相关的因素

Asthma Treatment Outcome and Factors Associated with Uncontrolled Asthma Among Adult Patients with Asthma in Addis Ababa, Ethiopia.

作者信息

Tsegaye Tesfaye, Gebretekle Gebremedhin Beedemariam, Ahmed Mohammedjud Hassen, Bayissa Tola, Habte Bruck Messele

机构信息

Department of Pharmacy, Mettu University, Mettu, Ethiopia.

Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

出版信息

J Asthma Allergy. 2022 Aug 12;15:1055-1063. doi: 10.2147/JAA.S373479. eCollection 2022.

Abstract

BACKGROUND

Asthma is a major public health challenge in the world resulting in significant health and economic burden. The modifiable and non-modifiable risk factors could have considerable impact on asthma control and medical care.

OBJECTIVE

This study is intended to evaluate the treatment outcome and identify risk factors for poor asthma control among patients with asthma in Addis Ababa, Ethiopia.

METHODS

A multicentre cross-sectional study using interview and chart review was conducted among patients with asthma attending ambulatory care of two large public hospitals in Addis Ababa, Ethiopia, between March and June 2018. The Global Initiative for Asthma Guideline was used to determine treatment outcomes. The variables of interest were described using descriptive statistics such as frequencies, percentages, mean, and standard deviations. Multivariable logistic regression was used to determine factors associated with uncontrolled asthma. All statistical significance level was determined at p < 0.05.

RESULTS

A total of 230 patients with asthma were interviewed. More than half (65.2%) of patients were females, and their mean age was 54 ± 15.1 years. Overall, 50.4% of the patients had uncontrolled asthma status. More than two number of trigger factors (AOR = 1.88; 95% CI: 1.09-2.01), cold weather (AOR = 2.11; 95% CI: 1.51-2.42), exacerbations of asthma in the last 12 months (AOR = 2.01; 95% CI: 1.39-2.32), moderate persistent asthma (AOR = 3.47; 95% CI: 1.75-5.13), severe persistent asthma (AOR = 2.90; 95% CI: 2.56-3.98), patients on Salbutamol puff with Beclomethasone (AOR = 2.92; 95% CI: 2.50-3.45) and patients on Salbutamol puff with Beclomethasone and Prednisolone (AOR = 5.76; 95% CI: 4.02-6.02) use were significantly associated with uncontrolled asthma.

CONCLUSION

More than half of patients with asthma had uncontrolled asthma treatment outcome. This indicates the need to give due attention to asthma patients with uncontrolled status, particularly to those with identified risk factors. Health care providers should work in creating patient awareness on appropriate use of their prescribed medications, avoidance of asthma triggering factors for decreasing the progression of the disease and better asthma control.

摘要

背景

哮喘是一项重大的全球公共卫生挑战,会导致严重的健康和经济负担。可改变和不可改变的风险因素可能对哮喘控制及医疗护理产生重大影响。

目的

本研究旨在评估埃塞俄比亚亚的斯亚贝巴哮喘患者的治疗效果,并确定哮喘控制不佳的风险因素。

方法

2018年3月至6月间,在埃塞俄比亚亚的斯亚贝巴两家大型公立医院接受门诊治疗的哮喘患者中,开展了一项采用访谈和病历审查的多中心横断面研究。采用全球哮喘防治创议指南来确定治疗效果。使用频率、百分比、均值和标准差等描述性统计方法对感兴趣的变量进行描述。采用多变量逻辑回归来确定与哮喘控制不佳相关的因素。所有统计显著性水平均确定为p<0.05。

结果

共访谈了230例哮喘患者。超过半数(65.2%)的患者为女性,平均年龄为54±15.1岁。总体而言,50.4%的患者哮喘控制不佳。超过两个触发因素(调整后比值比[AOR]=1.88;95%置信区间[CI]:1.09 - 2.01)、寒冷天气(AOR = 2.11;95%CI:1.51 - 2.42)、过去12个月内哮喘发作(AOR = 2.01;95%CI:1.39 - 2.32)、中度持续性哮喘(AOR = 3.47;95%CI:1.75 - 5.13)、重度持续性哮喘(AOR = 2.90;95%CI:2.56 - 3.98)、使用沙丁胺醇气雾剂联合倍氯米松的患者(AOR = 2.92;95%CI:2.50 - 3.45)以及使用沙丁胺醇气雾剂联合倍氯米松和泼尼松龙的患者(AOR = 5.76;95%CI:4.02 - 6.02)均与哮喘控制不佳显著相关。

结论

超过半数的哮喘患者治疗效果不佳。这表明需要对哮喘控制不佳的患者给予应有的关注,尤其是那些具有已确定风险因素的患者。医疗保健提供者应致力于提高患者对正确使用处方药的认识,避免哮喘触发因素,以减缓疾病进展并更好地控制哮喘。

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