沙特阿拉伯利雅得一家三级医院中住院哮喘儿童对哮喘药物的依从性：一项横断面研究
The adherence to asthma medication for hospitalized children with asthma: A cross-sectional study in a tertiary hospital in Riyadh, Saudi Arabia.
作者信息
Alghamdi Nawaf Abdullah, Alshammari Elaf A, Alsahli Afnan A, Abuhaimed Alanoud A, Alyousef Bader Y, Othman Fatmah, Abusido Tamer A, Alkhalaf Hamad Abdullah
机构信息
Department of Pediatric, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Medical Intern, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
出版信息
Ann Thorac Med. 2024 Jul-Sep;19(3):228-235. doi: 10.4103/atm.atm_24_24. Epub 2024 Jul 4.
AIM
The aim of the study was to assess adherence to asthma controller therapy and factors that influence asthma control and to determine the association between asthma knowledge of the caregiver and asthma control among admitted children with asthma.
SETTINGS AND DESIGN
A cross-sectional study was conducted between November 2022 and May 2023 in a tertiary care hospital. Children with a diagnosis of asthma aged 2-14 years, who were admitted to the hospital with an exacerbation of asthma were identified.
METHODS
Caregivers of the admitted children were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire.
STATISTICAL ANALYSIS USED
Demographic and clinical data were described using descriptive analyses, where mean and standard deviation were used for normally distributed continuous variables, median and interquartile range (IQR), if otherwise. A < 0.05 was set as a cutoff for statistical significance.
RESULTS
A total of 144 caregivers completed the survey. Median score for parents' knowledge of asthma was 64%, with an IQR of 59-67. Both mother's and father's educational levels were associated with a good level of knowledge: odds ratio (OR) = 2.48, 95% confidence interval (CI) = 1.1-5.6, and OR = 5.33, 95% CI = 2.23-12.7, respectively. Median adherence to metered dose inhaler (MDI) was 4 (IQR = 2-6). Children who had been admitted to the general ward in the last 6 months were three times more likely to be nonadherent to MDI (OR = 3.03, 95% CI = 1.18-7.82). Forty-three percent of children who were nonadherent to MDI were less likely to have their asthma controlled (OR = 0.43, 95% CI = 0.17-1.06).
CONCLUSION
This study revealed that a low level of knowledge among caregivers of asthma patients is linked to inadequate adherence to asthma controller therapy. As medication adherence is crucial for achieving desirable asthma control and improving the quality of life for this population, efforts need to be made to enhance the knowledge level of parents of children with asthma.
目的
本研究旨在评估哮喘控制治疗的依从性以及影响哮喘控制的因素，并确定哮喘患儿照料者的哮喘知识与哮喘控制之间的关联。
设置与设计
于2022年11月至2023年5月在一家三级护理医院进行了一项横断面研究。确定了年龄在2至14岁、因哮喘加重而入院的哮喘诊断患儿。
方法
使用哮喘知识问卷和儿科吸入器依从性问卷对入院患儿的照料者进行访谈。
所用统计分析方法
使用描述性分析描述人口统计学和临床数据，对于正态分布的连续变量使用均值和标准差，否则使用中位数和四分位间距（IQR）。设定P<0.05为具有统计学意义的临界值。
结果
共有144名照料者完成了调查。父母对哮喘知识的中位数得分是64%，IQR为59 - 67。母亲和父亲的教育水平均与良好的知识水平相关：优势比（OR）分别为2.48，95%置信区间（CI）=1.1 - 5.6，以及OR = 5.33，95% CI = 2.23 - 12.7。定量吸入器（MDI）的依从性中位数为4（IQR = 2 - 6）。过去6个月内在普通病房住院的儿童不依从MDI的可能性是其他儿童的三倍（OR = 3.03，95% CI = 1.18 - 7.82）。43%不依从MDI的儿童哮喘得到控制的可能性较小（OR = 0.43，95% CI = 0.17 - 1.06）。
结论
本研究表明，哮喘患者照料者的知识水平较低与哮喘控制治疗的依从性不足有关。由于药物依从性对于实现理想的哮喘控制和改善该人群的生活质量至关重要，因此需要努力提高哮喘患儿父母的知识水平。
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