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西班牙哮喘管理指南建议的依从水平

Level of Compliance with Spanish Guideline Recommendations in the Management of Asthma.

作者信息

Piñel Jimenez Lorena, Martinez Mesa Álvaro, Sanchez Alvarez Esther, Lopez Garcia Javier, Aguilar Galvez Ana, Reina Marfil Nuria, Gómez Rodríguez Belen, Cabrera Cesar Eva, Velasco Garrido Jose Luis

机构信息

Department of Pulmonology, Hospital Universitario Virgen de la Victoria, Málaga, Spain.

出版信息

J Asthma Allergy. 2024 Sep 16;17:879-887. doi: 10.2147/JAA.S433291. eCollection 2024.

Abstract

OBJECTIVE

To describe the clinical management of asthmatic patients and the level of compliance with the (GEMA, Spanish Guidelines for Asthma Management) in the influential al area of Virgen de la Victoria University Hospital, Málaga (Spain).

MATERIALS AND METHODS

Descriptive, cross-sectional study in asthma patients from the Virgen de la Victoria University Hospital influential area, Málaga (Spain). Asthma Control Test (ACT) results, demographic and clinical characteristics, and GEMA indicators of quality asthma care were obtained from each participating patient.

RESULTS

Two hundred and eighty-eight patients (64.2% woman, mean age 48.6 years) were included in the study. The evaluation of the level of compliance with the GEMA quality indicators showed that in 20.8% of the patients the diagnosis of asthma was confirmed by spirometry and bronchodilator test, and 52.5% of the patients with suspicion of allergic asthma performed a sensitization test. Among the smoker patients, 76.3% were recommended to stop smoking; 14.2% of the patients received a paper-based educational plan. Regarding asthma treatment, 92.3% of patients with persistent asthma received inhaled glucocorticoids (IGC). IGC and LABA were the most common treatments for asthma, used in combination (ICG + LABA) in 139 (48.3%) patients; 32.6% discontinued SABA treatment during the study period. Asthma was well controlled in 54.9% of the patients (ACT score ≥20), and 13.9% of the patients registered exacerbations during the previous year with a mean (SD) of 1.38 (0.74) events.

CONCLUSION

Most of the GEMA quality indicators of asthma care are not followed in real-world clinical practice. Specialists select the best option among the available treatments but there is an unmet need for training plans in other relevant aspects, such as diagnosis and/or disease monitoring.

摘要

目的

描述西班牙马拉加市维多利亚圣母大学医院影响区域内哮喘患者的临床管理情况以及对《西班牙哮喘管理指南》(GEMA)的依从水平。

材料与方法

对西班牙马拉加市维多利亚圣母大学医院影响区域内的哮喘患者进行描述性横断面研究。从每位参与研究的患者处获取哮喘控制测试(ACT)结果、人口统计学和临床特征以及哮喘优质护理的GEMA指标。

结果

288名患者(64.2%为女性,平均年龄48.6岁)纳入研究。对GEMA质量指标依从水平的评估显示,20.8%的患者通过肺功能测定和支气管扩张试验确诊哮喘,52.5%疑似过敏性哮喘的患者进行了致敏试验。在吸烟患者中,76.3%被建议戒烟;14.2%的患者接受了纸质教育计划。关于哮喘治疗,92.3%的持续性哮喘患者接受了吸入性糖皮质激素(IGC)治疗。IGC和长效β2受体激动剂(LABA)是最常用治疗哮喘的药物,139名(48.3%)患者联合使用(IGC + LABA);32.6%的患者在研究期间停用了短效β2受体激动剂(SABA)治疗。54.9%的患者哮喘得到良好控制(ACT评分≥20),13.9%的患者在前一年出现发作,平均(标准差)为1.38(0.74)次。

结论

在实际临床实践中,大多数GEMA哮喘护理质量指标未得到遵循。专科医生在现有治疗方法中选择了最佳方案,但在诊断和/或疾病监测等其他相关方面,培训计划的需求尚未得到满足。

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