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轻度哮喘——对患者及家长而言重要的事项。

Mild asthma-What matters to patients and parents.

作者信息

Greimann Emma, Freigeh George E, Wettenstein Rachel P, Nelson Belinda, Carpenter Laurie M, Mohan Arjun, Baptist Alan

机构信息

Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.

Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.

出版信息

Ann Allergy Asthma Immunol. 2025 Mar;134(3):290-295.e1. doi: 10.1016/j.anai.2024.11.017. Epub 2024 Nov 27.

Abstract

BACKGROUND

Mild asthma has received less attention despite accounting for most of patient with asthma. However, asthma complications including hospitalizations and progressive loss of lung function frequently occur in such patients. The priorities of patients with mild asthma are unknown, hindering the ability to advance care.

OBJECTIVE

To identify patient and parent perspectives on the definition of mild asthma, treatment preferences, concerns and goals of care.

METHODS

Participants with self-defined mild/intermittent asthma were recruited using emails distributed through the Allergy & Asthma Network and Allergy Foundation of America. A demographic survey and measures of asthma control/quality of life were completed. Focus groups consisting of approximately 5 participants and a focus group leader were conducted.

RESULTS

A total of 20 patients and 20 parents of children with mild asthma participated. Focus groups revealed significant variability in the definition and treatment preferences. Frequency of symptoms appears to be a key driver in treatment decisions for mild asthma, and those with infrequent symptoms were opposed to the addition of an inhaled corticosteroid to albuterol. Use of recommended asthma monitoring strategies such as asthma action plans or peak flow meters was low among adults. Participants desired more education from their providers regarding asthma remission and long-term complications associated with mild asthma.

CONCLUSION

There is significant heterogeneity in the definition and treatment preferences among patients and parents of those with mild asthma. Shared decision making between patients and providers is necessary to personalize medical decisions in those with mild asthma.

摘要

背景

轻度哮喘尽管占哮喘患者的大多数,但却较少受到关注。然而,此类患者经常出现包括住院和肺功能逐渐丧失在内的哮喘并发症。轻度哮喘患者的优先事项尚不清楚,这阻碍了改善治疗的能力。

目的

确定患者及家长对轻度哮喘的定义、治疗偏好、护理关注点及目标的看法。

方法

通过美国过敏与哮喘网络及美国过敏基金会发送的电子邮件招募自认为患有轻度/间歇性哮喘的参与者。完成了人口统计学调查以及哮喘控制/生活质量测量。开展了由约5名参与者和1名焦点小组组长组成的焦点小组讨论。

结果

共有20名轻度哮喘患者及20名患儿家长参与。焦点小组讨论显示,在定义和治疗偏好方面存在显著差异。症状出现频率似乎是轻度哮喘治疗决策的关键驱动因素,症状出现不频繁的患者反对在沙丁胺醇基础上加用吸入性糖皮质激素。成年人中使用哮喘行动计划或峰流速仪等推荐的哮喘监测策略的比例较低。参与者希望医生能提供更多关于轻度哮喘缓解及长期并发症的教育。

结论

轻度哮喘患者及其家长在定义和治疗偏好方面存在显著异质性。患者与医生之间的共同决策对于为轻度哮喘患者制定个性化医疗决策很有必要。

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