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家庭医生对哮喘患者口服皮质类固醇负担的认知

Family Physicians' Awareness of the Burden of Oral Corticosteroids in Asthma Patients.

作者信息

Stepanović Aleksander, Kopač Peter, Rotar Pavlič Danica

机构信息

Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Primary Health Care of Gorenjska Region, Health Center Škofja Loka, Slovenia.

Golnik University Clinic, Golnik, Slovenia; Department of Internal Medicine, Medical Faculty, University of Ljubljana, Slovenia.

出版信息

Acta Med Acad. 2024 Aug;53(2):199-208. doi: 10.5644/ama2006-124.446.

Abstract

OBJECTIVE

The objective of this study was to identify when family physicians decide to prescribe oral corticosteroids (OCS) to treat asthma, to establish the factors affecting their decision, and how familiar family physicians are with the side effects of OCS.

MATERIALS AND METHODS

A cross-sectional observational study was conducted among physicians that are members of the Slovenian Family Medicine Society.

RESULTS

The study included 122 family physicians from all 12 Slovenian regions. The great majority (86.9%) reported they had previously prescribed OCS to asthma patients. The largest share of these (45.1%) tended to prescribe a limited number of tablets, although many (42.6%) also prescribed the entire pack. Regarding the adverse effects associated with OCS, the physicians listed a range of potential problems, highlighting hyperglycemia and exacerbated diabetes, the impact on bone density, a suppressed immune system and increased risk of infection as the most common.

CONCLUSION

In the future, it is vital to improve family physicians' awareness of when OCS may be prescribed to treat severe asthma, and to define the clinical pathway for severe asthma, which should also involve interdisciplinary collaboration.

摘要

目的

本研究的目的是确定家庭医生何时决定开具口服糖皮质激素(OCS)来治疗哮喘,确定影响其决策的因素,以及家庭医生对OCS副作用的熟悉程度。

材料与方法

对斯洛文尼亚家庭医学协会的成员医生进行了一项横断面观察研究。

结果

该研究纳入了来自斯洛文尼亚所有12个地区的122名家庭医生。绝大多数(86.9%)报告称他们之前曾给哮喘患者开具过OCS。其中最大比例(45.1%)倾向于开具有限数量的片剂,不过也有许多人(42.6%)会开具整包药物。关于与OCS相关的不良反应,医生们列出了一系列潜在问题,其中最常见的是高血糖和糖尿病加重、对骨密度的影响、免疫系统抑制以及感染风险增加。

结论

未来,提高家庭医生对何时可开具OCS治疗重度哮喘的认识,并确定重度哮喘的临床路径至关重要,这也应涉及跨学科协作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41c6/11626237/ee72e81f8cd1/AMA-53-199-g001.jpg

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