Survey Of The Status Quo On Treatment And Control Of The Clinic Patients With Asthma

Objective: Bronchial asthma, Referred to as "Asthma", is a common chronicdisease. It is estimated that there are approximately300million asthma patients in theworld. The patients accounts for about10%of the world in China, about30million. Inorder to control the spread of asthma in the world effectively, the work in preventingand treating of asthma disease standard in clinical becomes inevitable. But that is notthe case, the majority of patients have not been able to accept the standardmanagement, resulting in poor asthma control, to bring the psychological and economicburden to patients and society. This topic is based on a questionnaire in patients withasthma who recently come to our hospital, to comprehend our current control status inpatients with asthma, provide the basis for prevention and control of asthma group.Methods:84outpatients with asthma were selected in the Second AffiliatedHospital of Dalian Medical University during Jan,2013to Mar,2013in Department ofinternal medicine respiratory and Asthma Clinic, which were accorded with thediagnostic standard of bronchial asthma GINA criteria from2011and Chinese guide forasthma in2008. Doctors of department of internal medicine clinic respiratory andAsthma Clinic in our hospital,interviewed outpatients in the form of face-to-facequestionnaire, using plain language to describe, investigated cases of asthma controland asthma patient’s condition.The contents of questionnaire were as follows:1.Thegeneral data of patients: Name，gender，age，disease duration，etc;2．The basic situation of asthma: The patient followed-up over the past one year and the conditions oftreatment and so on.3.The cases of asthma control:Included twostandards:(1)． According to the GINA(Global Initiative for Asthma) formulationcontrol level in2011;(2).ACT score.4. The onset of asthma: Included the onset ofrespiratory tract infections and the number of asthma in the past three months, the onsetof emergency the emergency treatment and hospitalization of asthma in the past year,etc. The questionnaire of84cases were completed and analyzed by SPSS17.0statisticalanalysis software, P <0.05was considered statistically significant.Result:1.Asthma clinical control level:(1) According to GINA criteria set by the2011asthma control level hierarchical, among which the asthma outpatient group was43.1%,respiratory outpatient group was18.2%(χ2=5.615, P <0.05), asthma outpatientwas obviously better than the respiratory outpatient, but less than the group thatstandardized management of education and treatment in our hospital in2011(62.8%).(2) In accordance with the ACT scores achieve good control above(ACT scorereach20points or higher),the asthma outpatient group was51.0%, the respiratoryoutpatient group was21.2%(χ2=7.444, P <0.05), asthma outpatient was obviouslybetter than the respiratory outpatient, but less than the group that standardizedmanagement of education and treatment in our hospital (74.4%).2.Inhaled glucocorticosteroid(ICS) therapy and respiratory tract infection:thepatients were divided into standardized treatment group and non standardized treatmentgroup. Standardized group refered to treatment with ICS or ICS+Long-acting BetaAgonists(LABA)last more than3months; non standardized group refered to treatmentwithout ICS or ICS+LABA, or even treatment with those medicine, but did not reach3months course of treatment. There were30(35.7%) patients in the standardizedtreatment group,54(64.3%) patients in the non standardized group. The situation ofrespiratory tract infection within3months, standardized group was66.7%, nonstandardized group was55.6%(χ2=0.988, P=0.361), no significant difference betweenthe two groups.3. The level of asthma control and respiratory tract infection: according to GINA criteria set by the2011,patients with asthma control hierarchical (control group) for28people, who were not achieve control (non control group) for56people, The situationof respiratory tract infection, control group was32.1%, non control group was58.9%,(χ2=5.357, P=5.357), the control group significantly lower than the non group.4.The level of asthma control and emergency treatment and hospitalization：according to the2011GINA criteria of asthma control level, control patients (controlgroup) for28people, did not reach the control patients (non control group) for56people, the patients who had emergency treatment and hospitalization over past12months, the control group was7.1%; the non control group was26.8%(χ2=4.462,P=0.044), the control group significantly lower than non control group.5.Medicine adherence and asthma control level: The patients who with lowmedicine adherence (12months outpatient service number was less than or equal1time)for35people, high medicine adherence of patients (12months outpatient servicenumber was more than or equal2times) for49people. The control rate of patients withlow medicine adherence was14.3%, the patients of high medicine adherence was46.9%(χ2=9.796, P=0.002), the rate of patients with high medicine was obviouslyhigher than that in patients with low medicine adherence.Conclusion: The standardized management can improve medicine adherence andcontrol level of patients with asthma, thereby reducing the patients with respiratorytract infection and probability of acute. It does not increase the risk of respiratory tractinfection if patients use ICS standardized.