为患有中度至重度喘的成年人采用和实施维持和缓解疗法
Sandra E Zaeh1, Zoe E Zimmerman1, Michelle N Eakin2
1Division of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut.
概括
对喘进行维持和缓解治疗 (MART) 的实施是有限的,只有不到15%的患者推这种方法. 许多临床医生很少或从不建议MART,这表明喘管理指南的采用存在差距.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 临床实践指南 临床实践指南
背景情况:
- 用吸入性皮质类固醇和长效支气管扩展剂进行维护和缓解疗法 (MART) 建议用于喘管理.
- 尽管自2020年12月以来已经纳入了指导方针,但关于MART实施的数据很少.
研究的目的:
- 评估在学术子专业实践中对中度至重度喘患者的MART建议的频率.
- 为了确定与MART建议相关的患者和临床医生因素.
主要方法:
- 电子医疗记录的回顾性横截面研究 (2021年1月 - 2023年10月).
- 分析患者人口统计,临床医生特征,并通过图表审查确认MART建议.
主要成果:
- 2016年仅有14.5%的患者被推接受MART治疗,87%的患者同时被处方短效支气管扩展剂.
- 吸入性皮质类固醇-formoterol的患者更有可能接受MART建议.
- 老年患者和接受医疗保险的人不太可能推MART;44%的临床医生从未推MART.
结论:
- 在学术子专业临床医生中观察到MART的有限实施.
- 很大一部分临床医生不经常推MART,突出了遵守指南的差距.
- 可能需要有针对性的干预措施来改善MART在喘护理中的采用.
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