Gonzales-Javier Gayle Therese K, Dans Leonila F, Tanega-Aliling Kristine, Tan-Lim Carol Stephanie C, Galingana Cara Lois T, Rey Mia P, Aquino Maria Rhodora D, Sanchez Josephine T, Dans Antonio L
Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila.
Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila.
Acta Med Philipp. 2025 Jan 15;59(1):84-90. doi: 10.47895/amp.vi0.8536. eCollection 2025.
Bronchial asthma is one of the most common chronic childhood diseases encountered in the primary care setting. Adherence to recommendations from clinical practice guidelines on asthma can be utilized as an indicator of quality of care when evaluating the implementation of the universal health care in the Philippines.
To determine the clinical profile of pediatric patients with bronchial asthma; and to evaluate the prescription patterns for asthma treatment in a primary care setting.
This was a retrospective cohort study that involved review of the electronic medical records in a rural site of the Philippine Primary Care Studies (PPCS). All patients less than 19 years old who were diagnosed with asthma from April 2019 to March 2021 were included. Quality indicators for asthma care were based on adherence to recommendations from the 2019 Global Initiative for Asthma (GINA) Guidelines.
This study included 240 asthmatic children with mean age of 6 years (SD ± 4.9) and a slight male preponderance (55.4%). Majority (138 children or 57.5%) were less than 6 years old. Out of the 240 children, 224 (93.3%) were prescribed inhaled short-acting beta-agonists (SABA) and 66 (27.5%) were prescribed oral SABA. Only 14 children (5.8%) were prescribed inhaled corticosteroids (ICS), with 13 children (5.4%) given ICS with long-acting beta-agonists (LABA) preparations, and one child (0.4%) given ICS alone. Quality indicators used in this study revealed underutilization of ICS treatment across all age groups, and an overuse of SABA-only treatment in children 6 years old and above. Moreover, 71.3% of the total patients were prescribed antibiotics despite the current GINA recommendation of prescribing antibiotics only for patients with strong evidence of lung infection, such as fever or radiographic evidence of pneumonia.
There were 240 children diagnosed with asthma over a 2-year period in a rural community, with a mean age of 6 years old and a slight male predominance. This quality-of-care study noted suboptimal adherence of rural health physicians to the treatment recommendations of the GINA guidelines, with overuse of SABA and underuse of ICS for asthma control.
支气管哮喘是基层医疗环境中最常见的儿童慢性疾病之一。在评估菲律宾全民医疗保健的实施情况时，遵循哮喘临床实践指南的建议可作为医疗质量的一项指标。
确定小儿支气管哮喘患者的临床特征；并评估基层医疗环境中哮喘治疗的处方模式。
这是一项回顾性队列研究，涉及对菲律宾基层医疗研究（PPCS）农村站点的电子病历进行回顾。纳入了2019年4月至2021年3月期间所有诊断为哮喘的19岁以下患者。哮喘护理的质量指标基于对2019年全球哮喘防治创议（GINA）指南建议的遵循情况。
本研究纳入了240名哮喘儿童，平均年龄6岁（标准差±4.9），男性略占优势（55.4%）。大多数（138名儿童或57.5%）年龄小于6岁。在这240名儿童中，224名（93.3%）被处方吸入短效β受体激动剂（SABA），66名（27.5%）被处方口服SABA。只有14名儿童（5.8%）被处方吸入性糖皮质激素（ICS），其中13名儿童（5.4%）接受ICS与长效β受体激动剂（LABA）制剂联合治疗，1名儿童（0.4%）仅接受ICS治疗。本研究中使用的质量指标显示，所有年龄组的ICS治疗使用不足，6岁及以上儿童过度使用仅SABA治疗。此外，尽管目前GINA建议仅对有肺部感染有力证据（如发热或肺炎影像学证据）的患者处方抗生素，但71.3%的患者被处方了抗生素。
在一个农村社区的两年时间里，有240名儿童被诊断为哮喘，平均年龄6岁，男性略占多数。这项医疗质量研究指出，农村卫生医生对GINA指南治疗建议的遵循情况欠佳，在哮喘控制方面存在SABA过度使用和ICS使用不足的情况。
