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APPaRENT 3:七个国家哮喘患者和医生对哮喘负担和管理的看法。

APPaRENT 3: Asthma Patients' and Physicians' Perspectives on the Burden and Management of Asthma in Seven Countries.

机构信息

General Medicines, GSK, 23 Rochester Park, #06-01, GSK Asia House, Singapore, 139234, Singapore.

Department of Medicine, College of Medicine, King Saudi Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.

出版信息

Adv Ther. 2024 Aug;41(8):3089-3118. doi: 10.1007/s12325-024-02900-2. Epub 2024 Jun 14.


DOI:10.1007/s12325-024-02900-2
PMID:38874879
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11263244/
Abstract

INTRODUCTION: Asthma management is strongly dependent on physician and patient beliefs and perceptions about the disease and its long-term treatment. The APPaRENT 3 study was conducted to explore factors influencing treatment choice and to understand patients' and physicians' attitudes and perspectives on the use of controller inhalers in regular versus flexible dosing for asthma management. METHODS: This cross-sectional survey of patients with asthma and treating physicians was conducted in seven countries: Indonesia, Malaysia, Philippines, Thailand, Vietnam (patient survey only), Saudi Arabia, and the United Arab Emirates. Assessment was carried out through an online/face-to-face questionnaire, where patients' viewpoints were focused on their attitudes and beliefs about asthma and treatment adherence, whereas physicians' viewpoints were gathered on their attitudes and beliefs about asthma management, knowledge of and adherence to asthma treatment guidelines, and asthma treatment regimens. RESULTS: Overall, 1400 patients (mean age, 34 years) and 599 physicians (mean age, 43 years) were included in the survey. Physicians similarly prioritised symptom control (39%) and exacerbation reduction (40%) in moderate asthma, whereas patients prioritised symptom control (41%) over exacerbation reduction (22%). Although both groups (physicians, 86%; patients, 84%) perceived asthma as well-controlled, poor management was evident based on Asthma Control Test (ACT) scores (mean, 15.7; standard deviation, 4.14; 82% had an ACT score < 20) and high symptom burden (39% reported nighttime awakenings or early mornings ≥ 2 nights/week). Most patients (76%) with moderate asthma were prescribed regular dosing, with the most common treatment being inhaled corticosteroid (ICS)/long-acting β-agonist (LABA) with as-needed inhaled short-acting β-agonist (SABA; 20%). Among patients on maintenance and reliever therapy, 93% of patients received a separate inhaled reliever. CONCLUSIONS: Despite high symptom burden, patients overestimated their level of asthma control. Physicians prioritised controlling symptoms and reducing exacerbations as treatment goals for moderate asthma, often prescribing regular dosing with ICS/LABA with as-needed inhaled SABA.

摘要

简介:哮喘管理很大程度上取决于医生和患者对疾病及其长期治疗的信念和认知。APPaRENT 3 研究旨在探索影响治疗选择的因素,并了解患者和医生对哮喘管理中使用控制吸入器的固定剂量与灵活剂量的态度和观点。

方法:本项在七个国家(印度尼西亚、马来西亚、菲律宾、泰国、越南[仅患者调查]、沙特阿拉伯和阿拉伯联合酋长国)进行的哮喘患者和治疗医生的横断面调查,通过在线/面对面问卷调查进行评估,其中患者的观点侧重于他们对哮喘和治疗依从性的态度和信念,而医生的观点则侧重于他们对哮喘管理、哮喘治疗指南的了解和遵循情况以及哮喘治疗方案的态度和信念。

结果:共有 1400 名患者(平均年龄 34 岁)和 599 名医生(平均年龄 43 岁)参与了调查。医生同样将症状控制(39%)和减少恶化(40%)作为中度哮喘的首要目标,而患者则将症状控制(41%)置于减少恶化(22%)之上。尽管两组(医生 86%;患者 84%)均认为哮喘得到了很好的控制,但基于哮喘控制测试(ACT)评分(平均 15.7,标准差 4.14;82%的 ACT 评分<20)和高症状负担(39%报告夜间觉醒或每周至少 2 次清晨醒来),不良管理情况明显。大多数中度哮喘患者(76%)接受了固定剂量治疗,最常见的治疗方法是吸入皮质类固醇(ICS)/长效β-激动剂(LABA)按需吸入短效β-激动剂(SABA;20%)。在接受维持和缓解治疗的患者中,93%的患者使用了单独的吸入缓解药物。

结论:尽管症状负担高,但患者高估了他们的哮喘控制水平。医生将控制症状和减少恶化作为中度哮喘的治疗目标,经常开具 ICS/LABA 加按需吸入 SABA 的固定剂量处方。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/83865e4932e8/12325_2024_2900_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/a6a7ee75a030/12325_2024_2900_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/6e0cdc7dcef6/12325_2024_2900_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/c63d6b3e6e0c/12325_2024_2900_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/83865e4932e8/12325_2024_2900_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/a6a7ee75a030/12325_2024_2900_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/6e0cdc7dcef6/12325_2024_2900_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/c63d6b3e6e0c/12325_2024_2900_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f63a/11263244/83865e4932e8/12325_2024_2900_Fig4_HTML.jpg

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本文引用的文献

[1]
The Saudi initiative for asthma - 2024 update: Guidelines for the diagnosis and management of asthma in adults and children.

Ann Thorac Med. 2024

[2]
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Open Respir Arch. 2023-9-19

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Understanding the Clinical Implications of Individual Patient Characteristics and Treatment Choice on the Risk of Exacerbation in Asthma Patients with Moderate-Severe Symptoms.

Adv Ther. 2023-10

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The role of modeling studies in asthma management and clinical decision-making: a Delphi survey of physician knowledge and perceptions.

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Adv Ther. 2023-4

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Patients' and physicians' perspectives on the burden and management of asthma: Results from the APPaRENT 2 study.

Respir Med. 2022-9

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