BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills ...BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.展开更多
Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment ...Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.展开更多
Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status...Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.展开更多
Background Asthma control in African Americans(AA)is considered more difficult to achieve than in Caucasian Americans(CA).The aim of this study was to compare asthma control over time among AA and CA children w hose a...Background Asthma control in African Americans(AA)is considered more difficult to achieve than in Caucasian Americans(CA).The aim of this study was to compare asthma control over time among AA and CA children w hose asthma is managed per NAEPP(EPR-3)guidelines.Methods This was a one-year prospective study of children referred by their primary care physicians for better asthma care in a specialty asthma clinic.All children received asthma care per NAEPP guidelines.Results were compared between CA and AA children at baseline and then at three-month intervals for one year.Results Of the 345 children,ages 2-17 years(mean=6.2±4),220(63.8%)were CA and 125(36.2%)were AA.There were no significant differences in demographics other than greater pet ownership in CA families.At baseline,AA children had significantly more visits to the Emergency Department for acute asthma symptoms(mean=2.3±3)compared to CA(1.4±23,P=0.003).There were no other significant differences in acute care utilization,asthma symptoms(mean days/month),or mean asthma control test(ACT)scores at base line.Within 3-6 months,in both groups,mean ACT scores,asthma symptoms and acute care utilization significantly improved(P<0.05 for all)and change over time in both groups was comparable except for a significantly greater decrease in ED visits in AA children compared to CA children(P=002).Conclusion Overall,improvement in asthma control during longitudinal assessment was similar between AA and CA children because of consistent use of NAEPP asthma care guidelines.展开更多
目的探讨儿童行为特点及其家庭管理方式对儿童哮喘控制水平影响路径。方法采用便利抽样法选取82例哮喘患儿,应用一般资料问卷、适应行为量表(AAMR)、家庭管理测量量表(FaMM)及儿童哮喘控制测试表(Childhood asthma control test,C-ACT)...目的探讨儿童行为特点及其家庭管理方式对儿童哮喘控制水平影响路径。方法采用便利抽样法选取82例哮喘患儿,应用一般资料问卷、适应行为量表(AAMR)、家庭管理测量量表(FaMM)及儿童哮喘控制测试表(Childhood asthma control test,C-ACT)进行问卷调查,分析其影响路径。结果患儿AAMR适应行为量表得分(84.87±9.16)分,FaMM量表得分(188.77±19.01)分,C-ACT得分(15.20±4.66)分。Pearson相关分析结果显示,适应性行为分别与家庭管理、哮喘控制呈正相关关系(r=0.580、0.219,P<0.05),家庭管理与哮喘控制呈正相关关系(r=0.401,P<0.05)。结构方程模型结果表明,家庭管理在哮喘患儿适应性行为和哮喘控制有部分中介调节作用,效应占比为45.95%。结论儿童行为特点能够通过家庭管理方式对患儿哮喘控制水平产生影响,临床护理人员应重视对患儿家属的健康教育管理,提升家属对疾病的认知度及家庭管理能力,以改善患儿的行为方式,达到有效控制患儿疾病的目的。展开更多
目的分析门诊成人支气管哮喘患者的临床控制水平及其影响因素,为哮喘的规范化治疗提供参考。方法选取2017年7月至2022年7月上海中医药大学附属龙华医院呼吸科门诊就诊的100例成人哮喘患者,根据哮喘控制测试(asthma control test,ACT)评...目的分析门诊成人支气管哮喘患者的临床控制水平及其影响因素,为哮喘的规范化治疗提供参考。方法选取2017年7月至2022年7月上海中医药大学附属龙华医院呼吸科门诊就诊的100例成人哮喘患者,根据哮喘控制测试(asthma control test,ACT)评分表评估患者哮喘控制水平,将患者分为控制良好组(n=36)与未控制组(n=64)。采用多因素Logistic回归分析门诊成人支气管哮喘患者控制水平的影响因素。结果100例门诊成人支气管哮喘患者的控制率(ACT≥20分)为36%。单因素Logistic回归分析显示两组患者的性别、年龄、吸烟史、家族史、急性加重住院史、合并过敏性鼻窦炎、肺功能等差异无统计学意义(P>0.05)。两组患者的BMI、FeNO、嗜酸性粒细胞计数以及嗜酸性粒细胞百分比差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,有吸烟史、发病年龄≤33岁、FeNO>54ppb、血嗜酸性粒细胞百分比>5.5%是影响门诊成人支气管哮喘患者控制水平的危险因素(P<0.05)。ROC曲线分析显示,以Logistic回归分析总体模型为检验变量时,曲线下面积最大(0.778)。结论门诊成人支气管哮喘患者控制水平未达理想标准。有吸烟史、发病年龄小、FeNO水平高、血嗜酸粒细胞百分比高是影响门诊成人支气管哮喘患者控制水平的危险因素。展开更多
Aim of the Study: To compare effect of asthma care by pharmacist intervention versus routine care on asthma control. Patients and Methods: A 2-month randomised, controlled trial was conducted in outpatient clinics of ...Aim of the Study: To compare effect of asthma care by pharmacist intervention versus routine care on asthma control. Patients and Methods: A 2-month randomised, controlled trial was conducted in outpatient clinics of Ain Shams University Hospitals, Cairo, Egypt. Patients were randomly assigned to receive routine care or a pre-defined pharmacist intervention. This intervention was mainly focused on patient education, improving inhalation technique and medication assessment. Primary outcome was the level of asthma control, as assessed by the Asthma Control Questionnaire (ACQ). Results: By the end of the study, intervention patients who received a written action plan significantly improved their ACQ results than routine care group who did not receive a plan (p < 0.0001). Inhalation technique and adherence to controller medication were significantly better in the intervention group. Conclusion: The present study results provide supportive evidence concerning pharmacists’ favourable effects on asthma patient care and support pharmacists as valuable members of the health care team.展开更多
基金Supported by Science and Technology Research Project of Songjiang District,No.2020SJ340.
文摘BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.
文摘Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.
文摘Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.
文摘Background Asthma control in African Americans(AA)is considered more difficult to achieve than in Caucasian Americans(CA).The aim of this study was to compare asthma control over time among AA and CA children w hose asthma is managed per NAEPP(EPR-3)guidelines.Methods This was a one-year prospective study of children referred by their primary care physicians for better asthma care in a specialty asthma clinic.All children received asthma care per NAEPP guidelines.Results were compared between CA and AA children at baseline and then at three-month intervals for one year.Results Of the 345 children,ages 2-17 years(mean=6.2±4),220(63.8%)were CA and 125(36.2%)were AA.There were no significant differences in demographics other than greater pet ownership in CA families.At baseline,AA children had significantly more visits to the Emergency Department for acute asthma symptoms(mean=2.3±3)compared to CA(1.4±23,P=0.003).There were no other significant differences in acute care utilization,asthma symptoms(mean days/month),or mean asthma control test(ACT)scores at base line.Within 3-6 months,in both groups,mean ACT scores,asthma symptoms and acute care utilization significantly improved(P<0.05 for all)and change over time in both groups was comparable except for a significantly greater decrease in ED visits in AA children compared to CA children(P=002).Conclusion Overall,improvement in asthma control during longitudinal assessment was similar between AA and CA children because of consistent use of NAEPP asthma care guidelines.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 30971326 and No. 30901907）Sichuan Youth Science ＆ Technology Foundation （No. 2010JQ008）, and Youth Science Funding of Sichuan University （No. 2011SCU04B 17）.
文摘目的探讨儿童行为特点及其家庭管理方式对儿童哮喘控制水平影响路径。方法采用便利抽样法选取82例哮喘患儿,应用一般资料问卷、适应行为量表(AAMR)、家庭管理测量量表(FaMM)及儿童哮喘控制测试表(Childhood asthma control test,C-ACT)进行问卷调查,分析其影响路径。结果患儿AAMR适应行为量表得分(84.87±9.16)分,FaMM量表得分(188.77±19.01)分,C-ACT得分(15.20±4.66)分。Pearson相关分析结果显示,适应性行为分别与家庭管理、哮喘控制呈正相关关系(r=0.580、0.219,P<0.05),家庭管理与哮喘控制呈正相关关系(r=0.401,P<0.05)。结构方程模型结果表明,家庭管理在哮喘患儿适应性行为和哮喘控制有部分中介调节作用,效应占比为45.95%。结论儿童行为特点能够通过家庭管理方式对患儿哮喘控制水平产生影响,临床护理人员应重视对患儿家属的健康教育管理,提升家属对疾病的认知度及家庭管理能力,以改善患儿的行为方式,达到有效控制患儿疾病的目的。
文摘目的分析门诊成人支气管哮喘患者的临床控制水平及其影响因素,为哮喘的规范化治疗提供参考。方法选取2017年7月至2022年7月上海中医药大学附属龙华医院呼吸科门诊就诊的100例成人哮喘患者,根据哮喘控制测试(asthma control test,ACT)评分表评估患者哮喘控制水平,将患者分为控制良好组(n=36)与未控制组(n=64)。采用多因素Logistic回归分析门诊成人支气管哮喘患者控制水平的影响因素。结果100例门诊成人支气管哮喘患者的控制率(ACT≥20分)为36%。单因素Logistic回归分析显示两组患者的性别、年龄、吸烟史、家族史、急性加重住院史、合并过敏性鼻窦炎、肺功能等差异无统计学意义(P>0.05)。两组患者的BMI、FeNO、嗜酸性粒细胞计数以及嗜酸性粒细胞百分比差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,有吸烟史、发病年龄≤33岁、FeNO>54ppb、血嗜酸性粒细胞百分比>5.5%是影响门诊成人支气管哮喘患者控制水平的危险因素(P<0.05)。ROC曲线分析显示,以Logistic回归分析总体模型为检验变量时,曲线下面积最大(0.778)。结论门诊成人支气管哮喘患者控制水平未达理想标准。有吸烟史、发病年龄小、FeNO水平高、血嗜酸粒细胞百分比高是影响门诊成人支气管哮喘患者控制水平的危险因素。
文摘Aim of the Study: To compare effect of asthma care by pharmacist intervention versus routine care on asthma control. Patients and Methods: A 2-month randomised, controlled trial was conducted in outpatient clinics of Ain Shams University Hospitals, Cairo, Egypt. Patients were randomly assigned to receive routine care or a pre-defined pharmacist intervention. This intervention was mainly focused on patient education, improving inhalation technique and medication assessment. Primary outcome was the level of asthma control, as assessed by the Asthma Control Questionnaire (ACQ). Results: By the end of the study, intervention patients who received a written action plan significantly improved their ACQ results than routine care group who did not receive a plan (p < 0.0001). Inhalation technique and adherence to controller medication were significantly better in the intervention group. Conclusion: The present study results provide supportive evidence concerning pharmacists’ favourable effects on asthma patient care and support pharmacists as valuable members of the health care team.
