喘时的三重吸入疗法:信念,行为和怀疑
D Bagnasco1, I Ansotegui2, I Baiardini1
1Respiratory Diseases and Allergy Department, IRCCS Polyclinic Hospital San Martino, Genoa, Italy; Department of Internal Medicine (DiMI), University of Genoa, Italy.
Pulmonary pharmacology & therapeutics
|November 21, 2024
概括
吸入式三重疗法 (ICS-LABA-LAMA) 在喘管理中未得到充分利用,尽管有证明的好处. 一项调查揭示了其应用方面的专业不确定性,表明需要更好地将研究纳入实践.
科学领域:
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
- 临床实践 临床实践
背景情况:
- 根据GINA指导方针,长效肌肉抗剂 (LAMA) 与吸入性皮质类固醇 (ICS) 和长效β-2激动剂 (LABA) 结合,代表了喘的先进治疗选择.
- 尽管已确立有效性和安全性,但吸入式三重疗法 (ITT) 在喘专家中受到了有限的采用.
研究的目的:
- 调查喘专家关于使用吸入式三重疗法 (ITT) 的信念和行为.
- 确定影响ITT在喘管理中的处方模式和临床定位的因素.
主要方法:
- 由Interasma科学网络 (INESnet) 专家开发了一项特设调查,通过Delphi轮进行了改进.
- 该问卷通过社交媒体在国际上分发 (2023年6月至9月),并使用描述性统计和斯皮尔曼非参数测试进行分析.
- 314个已填写的问卷提供了临床医生对ITT态度的数据.
主要成果:
- 只有35.7%的专家认为ITT是主要的治疗选择,61.8%认为它是高剂量ICS-LABA之后的二线选择.
- 显著多数 (89.2%) 同意,优化吸入疗法应该先于使用生物制剂.
- 持续的空气流限制和高可逆性被确定为对ITT反应的预测因素.
结论:
- 喘专家认为ITT是治疗持续性喘的重要工具.
- 尽管人们意识到其在减少恶化和改善肺功能方面的好处,但关于其最佳临床定位的不确定性仍然存在.
- 需要进一步的举措来弥合研究成果和日常临床实践之间的差距,以便有效地整合ITT.
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