[Evaluation of asthma management from the surveys in 30 provinces of China in 2015-2016]

Zhonghua Nei Ke Za Zhi. 2018 Jan 1;57(1):15-20. doi: 10.3760/cma.j.issn.0578-1426.2018.01.003.
[Article in Chinese]

Abstract

Objective: To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods: A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test, medication choice of maintenance therapy and asthma education. Results: A total of 3 875 asthmatic outpatients were recruited including 2 347(60.6%) females and 1 528(39.4%) males. The mean age was (50.7±16.7) years ranging from 14 to 99. Only 10.1%(388/3 837) patients used PFM as monitoring, whereas 62.1%(2 405/3 874) patients underwent pulmonary function test during the past year. There were 57.4%(2 226/3 875) patients treated with inhaled cortical steroid plus long-acting β(2)-agonist combinations (ICS+LABA) as daily medication. 43.3%(1 661/3 836) patients were followed up by physicians. Among this population, 1 362 asthmatic outpatients were recruited, who also took part in the asthma control survey in 2007-2008 in 10 cities. In this subgroup, 17.9%(244/1 360) were tested by PFM and 66.6%(907/1 362) by pulmonary function test during last year. As to the medication, 63.1%(860/1 362) selected ICS+LABA for daily control. There were 50.4%(685/1 359) patients in the follow-up cohort by physicians. Compared to the similar survey conducted in 2007-2008, the proportion of patients with ICS+LABA regimen and follow-up by physicians were markedly higher, while the rate of PFM use did not have significant improvement. Conclusion: Although the present level of asthma management in China is still far from ideal, asthma management has improved compared to 8 years ago. Yet the use of PFM does not significantly improve. Asthma action plan and application of PFM should be further promoted to improve the level of asthma management.

目的: 评估我国城区支气管哮喘(以下简称哮喘)患者哮喘管理水平,为今后开展全国哮喘管理计划提供参考依据。 方法: 多中心横断面研究。2015年10月—2016年5月在全国哮喘研究协作组成员所在30个城市的30家三级甲等医院呼吸内科门诊进行面对面问卷调查,调查内容包括哮喘管理(峰流速仪使用、肺功能检测)、维持治疗药物使用、哮喘教育(哮喘行动计划、医院哮喘教育),分析我国现阶段城区哮喘患者哮喘管理水平。 结果: 共纳入3 875例门诊哮喘患者,女2 347例(60.6%),男1 528例(39.4%),年龄14~99(50.7±16.7)岁。10.1%(388/3 837)的患者使用过峰流速仪,既往一年内62.1%(2 405/3 874)的患者做过肺功能检查,57.4%(2 226/3 875)的患者选择含吸入糖皮质激素(ICS)联合长效β(2)受体激动剂(LABA)作为每日规律使用的控制性药物,43.3%(1 661/3 836)的患者有专科医生制定哮喘治疗(随访)行动计划。其中,曾在2007—2008年哮喘控制调查的10个城市在本次调查中共纳入1 362例,17.9%(244/1 360)的患者使用过峰流速仪,既往一年内66.6%(907/1 362)的患者做过肺功能检查,63.1%(860/1 362)的患者选择ICS+LABA作为每日规律使用的控制性药物,50.4%(685/1 359)的患者有专科医生制定的哮喘治疗(随访)行动计划。与2007—2008年的调查结果相比,选用ICS+LABA作为每日规律使用的控制性药物及有专科医师制定哮喘治疗(随访)计划的比例明显升高,峰流速仪的使用率未见显著改善。 结论: 目前我国哮喘总体管理水平尚不理想,曾在2007—2008年哮喘调查的10城市中可以看到,哮喘管理水平在提高,而峰流速仪使用率较8年前未有显著改善。应大力推广哮喘行动计划及峰流速仪的使用,以提高哮喘管理水平。.

Keywords: Asthma; Asthma management; Multi-center, cross-sectional investigation; Questionnaires.

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / epidemiology
  • China / epidemiology
  • Cities
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data*
  • Physicians
  • Surveys and Questionnaires
  • Urban Population

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents