| Background: asthma is a chronic disease in the worldwide, about 300 million patients undergoing the harm brought by the diease in nearly 20 years, and its incidence is increasing continuously, particularly in children. By now asthma is still not cured completely, and the therapeutic aim is to achieve and get the long-term control of the clinical symptoms. The series survey of AIR(Asthma Insights and Reality) about the current situation of Asthma control Global found that in Western Europe, the ratio of asthma patients who achieve the Asthma control level defined by global Asthma control motion-initiating (GINA) is only about 5%. In the Asia-Pacific region, the proportion of the patients who are using inhaled corticosteroids to treat asthma is 9%, which is only 6% in China (Beijing, Shanghai, Guangzhou). Recently there was another investigation finished by eight countries in European Union; The survey was performed in certail asthma patients who were using inhaled corticosteroids or conjoined therapy and ained to get the data about the current situation of asthma control and the patients' acknowledge degree about asthma. The results showed the proportion of the patients who still need daily using catabatic drugs is 74%. According to ACQ, only 30% of patients reached good control, 47% of patients need medical intervention at least once a year, and the control level of asthma patients is overvalued. But the gaining optimal asthma control study(GOAL) found that nearly 50% of patients can achieve complete control, 80% of patients can achieve good control in a year's study according to the guidelines for the classification and treatment of asthma. The great contrast mdicates the importance of the long-term management of asthma.significance of the investigation : There isn't a systemic investigation about the situation of the control about asthma yet in Changsha. The main significance of the investigation lies in: (1) Find out the patients' acknowledge degree about asthma and the current situation of the disease' control in Changsha city. Evaluate the effects of spreading normalized treatment.,and supply the reference frame of the job in the prevention and treatment of asthma; (2) The materials can be used as a baseline data in the future again, it has important value for evaluation and follow-up. (3) The study could help us accumulate experience for future large-scale epidemiological investigation and the job about the prevention and treatment of asthma.Respondents and research approach: 1. Respondents:①The outpatients get outpatient service from July 2007 to Match 2008 in asthmatic of the secend xiangya hospital of central south university, xiangya hospital of central south university, the people's hospital of Hunan province and the geriatric conditions hospital of Hunan province.②According to the diagnostic standard which was formulated by Chinese Medical Association.③Age: more than 14years old.④The patients had been diagnosed more than a month,and lived in Changsha more than a year. 2. Research approach: The questionnaire were performed between the doctors and the patients in a face-to-face way. Designing the table by refering to the AIR, INSPIRE, asthma control test (ACT), and combine with the actual situation in our country. The main contents of questionnaire include general larithmics data, the situation of asthma control, drug therapy, signs of asthma attacks and self management. The were 148 completed questionnaires in total.Results:1. General information The median age of the patients: 48.7±17.3(14～78) years old and disease duration time: (14.6±16.1) years. Male/Female ratio : 1/1.23 (66/81). 89.2% of the patientshad the educational background exceeding the degree of primary school. The proportion of the patients who had smoking history is 28.4%. Various forms of social insurances covered 68.3% of the astnmatic patients.2. Asthma control status and medication : 25.7% of the asthmatics had been hospitalized and 38.5% had visited emergency department because of asthma exacerbation in the past years. The percentage of adults with work loss caused by asthma was 23.4%(11/47), and that of children with school loss was 73.3%(11/15). According to the control level classification of asthma, 27.9% of the asthmatic patients achieved disease control, 39.7% achieved portion control and 32.4% uncontrolled. Only 8.2% of the patients had used peak flowmeter and 37.5% of the patients monitored the peak flow regularly. 16.7% of the patients had the record of peak flowmeter. the long-term treatment plan of asthma drawn up by doctors coverd 25.7% of the patients. 52.7% of the patients received daily controll therapy with inhaled corticosteroids regularly. According to asthma control test (ACT), 4.2% of the astnmatic patients achieved complete control and 32.2% achieved well controll. The situation of drug treatment: 14.9% of the patient did not receive daily controll therapy. Using ICS and LABA as daily controll in drug coverd 51.2% of the patients.3. Signs of asthma attacks and self management: The asthmatic paroxysm in nearly half (40.1%) of the patients become irregular during the past year, Asthmatic deterioration limits 73.6% of patients' daily movement. 51.3% of the patients said that they had confidence to controll the disease without hospitalizing when asthma was deterioated. 75.7% of the patient had signs before asthma attacting, and the main signs were chest distress(71.6%), cough(72.3%) and tachypnea(77.0%). The time from the signs appearinf to asthma-attacking was for an average of 14.4±24.1 hours, and the median was 10 hours. 63.0% of the patients used antispasmodic first when asthma attacking. 4. Acknowledge of asthma: 53.4% of the patients believed that asthma was a kind of airway inflammatory disease. Inhaled corticosteroids was the first choice of 43.9% of the patients in asthma duration period. 78.4% of the patients believed that the aerosol of SABA should be used when the disease had an acute exacerbation. 70.6% of the patients said the reason without using peak flowmeter was that they weren't introduced to use it. Folk prescription had once been used by 25.1% of the patients, but 79.7% said that they wouid not use it again. 70.3% of the patients could accept that the goal of asthma therapy is long-term well control. 33.8% of the patients had participated the course of lectures about asthma held by hospital. The main approach for the patients to get the knowledge of asthma was from the doctors, secondly was from books. Only 6.1 % of patients had visited the website of China's asthma alliance.Conclusions: Even though the patients' current situation of asthma control in Changsha City was worse than that of nationwide, contrast to the past, the proportion of the patients who got control medcine has been increased. We have got some achievement of in asthma prevention and treatment, but the asthma patient's cognitive degree should been improved. In order to increase the universal education of asthma acknowledge, we still have lots of work to do. |
PDF Full Text Request