Avtor/Urednik		Šuškovič, Stanislav; Košnik, Mitja
Naslov		Zavzetost za zdravljenje z inhalacijskimi glukokortikoidi pri bolnikih z astmo
Prevedeni naslov		Compliance with the treatment with inhaled glucocorticoids in asthmatic patients
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 70, št. 1
Leto izdaje		2001
Obseg		str. 19-22
Jezik		slo
Abstrakt		Background. Slovenian guidelines for asthma management (1) are basic information for treatment asthmatic patients. It is not known in what extent are asthmatic patients in Slovenia treated according to guidelines. We tried to find out what proportion of asthmatic patients are properly treated with inhaled glucocorticoids. Methods. In the study were included 43 asthmatics, who were routinely examined in outpatients department. 25 of them (group A) were correctly treated with inhaled glucocorticoids budesonide, fluticasone or flunisolide. Another 18 asthmatics (group B) were not prescribed with inhaled glucocorticoid, though they should be, according to their persistent asthma. We prescribed to them inhaled budesonide in dose 400 ug B.I.D. Both groups were followed for 4 weeks. Patients measured every morning and evening peak expiratory flow (PEF) and presence of symptoms cough, dyspnoe, chest tightness and nocturnal asthma filled in diary. Results. 18 out of 43 (42%) asthmatic patients were not properly treated with inhaled glucocorticoids. After 4 weeks of treatment (patient in group A were treated with the same inhaled glucocorticoids, as before the study) were all symptoms statistically significantly reduced in both groups of patients. In group A morning PEF increase from 285 L/min (SE 24 L/min) to 335 L/min, SE 30 L/min, p=0.004) and evening PEF increased from 304 L/min (SE 25 L/min) to 344 L/min (SE 33 L/min, p = 0.04). Changes of PEF in group B were positive, but statistically not significant. Conclusions. It can be concluded, that some asthmatic patients are not treated according to national guidelines. Improvement in PEF and reducing of symptoms in group A could be attributed to regular measurements of PEF and symptoms which probably remined the patient to took the medications. In this simple way compliance to prescribed inhaled glucocorticoid was probably increased. Education of physicians and patients with asthma should be reinforced.
Izvleček		Izhodišča. Slovenske smernice za obravnavo bolnika z astmo (1) so osnovno vodilo za zdravljenje astme pri nas. Ni znano, v kolikšni meri je zdravljenje bolnikov z astmo prilagojeno smernicam. V preizkusu sva želela ugotoviti delež ambulantnih bolnikov, ki imajo pravilno predpisan inhalacijski glikokortikoid. Bolnike, ki inhalacijskega glukokortikoida niso imeli predpisanega, čeprav bi ga potrebovali, sva 4 tedne zdravila z budezonidom. Izvid zdravljenja sva vrednotila s spremljanjem simptomov in merjenji največjega ekspiratornega pretoka (PEF). Kontrolno skupino so predstavljali bolniki, ki so že imeli predpisan inhalacijski budezonid, flutikazon ali flunizolid. Metode. V raziskavo sva vključila bolnike z astmo, napotene na ambulantni pregled. V raziskavo sva vključila 25 bolnikov z astmo (16 žensk), ki so bili najmanj 3 zadnje mesece zdravljeni z inhalacijskim glukokortikoidom v odmerku 200 ug-500ug/12 ur (skupina A). Tem bolnikom nisva spremenila načina zdravljenja. Vključila sva tudi 18 bolnikov (10 žensk), ki sva jim prvič predpisala inhalacijski budezonid v odmerku 400 ug/12 ur (skupina B). Bolniki so vsakodnevno zjutraj in zvečer merili PEF. Ocenjevali so kašelj, oteženo dihanje, stiskanje v prsih in nočno astmo. Rezultati. 18 od 43 (42%) naključno pregledanih bolnikov z astmo ni bilo zdravljenih po navodilih smernic (1). Skupini A in B se po starosti ali spolu, začetnih jutranjih in večernih vrednostih PEF ali začetnih simptomih nista ločili. Po 4 tednih zdravljenja so se vsi spremljani simptomi v obeh skupinah bolnikov statistično pomembno zmanjšali. V skupini A sta se jutranji PEF (285L/min, SE 24L/min) in večerni PEF (304L/min, SE 25L/min) po 4 tednih zdravljenja statistično pomembno povečala (na 335 L/min, SE 30 L/min, p= 0,004, oziroma na 344 L/min, SE 33 L/min, p=0,04). V skupini B se vrednosti PEF niso statistično pomembno spremenile. Zaključki. Ocenjujeva, da so nekateri bolniki z astmo nepravilno zdravljeni. (Izvleček prekinjen pri 2000 znakih).
Deskriptorji		ASTHMA GLUCOCORTICOIDS, SYNTHETIC ADMINISTRATION, INHALATION PATIENT COMPLIANCE PATIENT EDUCATION PEAK EXPIRATORY FLOW RATE TREATMENT OUTCOME