PDF(Sci-hub)
Abstract：
BACKGROUND: Patient awareness of asthma severity is important for optimal asthma management. However, there is often a discrepancy between physician assessment of asthma control based on guidelines and patient discernment of control. We compared physician and patient perception of asthma control in a clinic population seen at a tertiary hospital in Addis Ababa, Ethiopia.
METHODS: In this cross-sectional study, 182 consecutive patients with a physician diagnosis of asthma seen in Chest Clinic at Tikur Anbessa Specialized Hospital (TASH) between July and December 2015 were studied. Demographics, asthma symptoms, medication use in the past month, and self-perception of asthma control in the past 7 days were obtained from the clinic records. Physician assessed asthma control was based on the GINA asthma symptom control assessment tool. Lung function was measured using a Diagnostic EasyOne Plus model 2001 SN spirometer. The institutional review board approved the study protocol.
RESULTS: Of the 182 subjects, 68.1% were female. The mean age was 52 ± 12 years, and the mean (SD) duration of asthma was 19.4 ± 12.7 years. Forty-four (24.2%) patients had physician determined well-controlled asthma and 138 (75.8%) patients had physician determined partly controlled/uncontrolled asthma. One hundred and fifty-one (83%) patients thought their asthma control was good. However, the degree of concordance between physician evaluation and patient perception of asthma control was low (kappa index = 0.09). On multivariate analysis, self-perceived poor asthma control was associated with any activity limitation due to asthma and inconsistent inhaled corticosteroid use.
CONCLUSIONS: In our study, the first of its kind in Ethiopia, a high percent of patients with physician determined well-controlled asthma has appropriate perception of their disease state. However, those patients with partly controlled/uncontrolled asthma had poor self-perception of their disease, emphasizing the need for further patient education. These conclusions may be especially useful in the care of asthmatics from other low-income countries.
METHODS: In this cross-sectional study, 182 consecutive patients with a physician diagnosis of asthma seen in Chest Clinic at Tikur Anbessa Specialized Hospital (TASH) between July and December 2015 were studied. Demographics, asthma symptoms, medication use in the past month, and self-perception of asthma control in the past 7 days were obtained from the clinic records. Physician assessed asthma control was based on the GINA asthma symptom control assessment tool. Lung function was measured using a Diagnostic EasyOne Plus model 2001 SN spirometer. The institutional review board approved the study protocol.
RESULTS: Of the 182 subjects, 68.1% were female. The mean age was 52 ± 12 years, and the mean (SD) duration of asthma was 19.4 ± 12.7 years. Forty-four (24.2%) patients had physician determined well-controlled asthma and 138 (75.8%) patients had physician determined partly controlled/uncontrolled asthma. One hundred and fifty-one (83%) patients thought their asthma control was good. However, the degree of concordance between physician evaluation and patient perception of asthma control was low (kappa index = 0.09). On multivariate analysis, self-perceived poor asthma control was associated with any activity limitation due to asthma and inconsistent inhaled corticosteroid use.
CONCLUSIONS: In our study, the first of its kind in Ethiopia, a high percent of patients with physician determined well-controlled asthma has appropriate perception of their disease state. However, those patients with partly controlled/uncontrolled asthma had poor self-perception of their disease, emphasizing the need for further patient education. These conclusions may be especially useful in the care of asthmatics from other low-income countries.
摘要：
背景：患者对哮喘严重程度的认识对于优化哮喘管理很重要。然而,基于指南的医师对哮喘控制的评估和患者对控制的辨别通常存在差异.我们比较了在亚的斯亚贝巴三级医院就诊的临床人群中，医师和患者对哮喘控制的看法。埃塞俄比亚。
方法：在这项横断面研究中，研究了2015年7月至12月在TikurAnbessa专科医院（TASH）的胸科诊所就诊的182例连续哮喘患者。人口统计,哮喘症状,过去一个月的药物使用情况，从临床记录中获得过去7天内哮喘控制的自我感知。医师评估哮喘控制是基于GINA哮喘症状控制评估工具。使用诊断EasyOnePlus模型2001SN肺活量计测量肺功能。机构审查委员会批准了研究方案。
结果：在182名受试者中，68.1%为女性。平均年龄为52±12岁,哮喘的平均持续时间（SD）为19.4±12.7年。44例（24.2%）患者有医生确定的哮喘控制良好，138例（75.8%）患者有医生确定的部分控制/不受控制的哮喘。101名（83％）患者认为他们的哮喘控制良好。然而,医师评价与患者对哮喘控制的认知之间的一致性程度较低(kappa指数=0.09).在多变量分析中，自感的哮喘控制不佳与哮喘引起的活动受限和吸入糖皮质激素使用不一致相关.
结论：在我们的研究中，这是埃塞俄比亚第一个这样的国家，有医生认为哮喘控制良好的患者中有很高的百分比对他们的疾病状态有适当的认识.然而,那些部分控制/不受控制的哮喘患者对疾病的自我感知较差，强调需要进一步的病人教育。这些结论可能对其他低收入国家的哮喘患者的治疗特别有用。
方法：在这项横断面研究中，研究了2015年7月至12月在TikurAnbessa专科医院（TASH）的胸科诊所就诊的182例连续哮喘患者。人口统计,哮喘症状,过去一个月的药物使用情况，从临床记录中获得过去7天内哮喘控制的自我感知。医师评估哮喘控制是基于GINA哮喘症状控制评估工具。使用诊断EasyOnePlus模型2001SN肺活量计测量肺功能。机构审查委员会批准了研究方案。
结果：在182名受试者中，68.1%为女性。平均年龄为52±12岁,哮喘的平均持续时间（SD）为19.4±12.7年。44例（24.2%）患者有医生确定的哮喘控制良好，138例（75.8%）患者有医生确定的部分控制/不受控制的哮喘。101名（83％）患者认为他们的哮喘控制良好。然而,医师评价与患者对哮喘控制的认知之间的一致性程度较低(kappa指数=0.09).在多变量分析中，自感的哮喘控制不佳与哮喘引起的活动受限和吸入糖皮质激素使用不一致相关.
结论：在我们的研究中，这是埃塞俄比亚第一个这样的国家，有医生认为哮喘控制良好的患者中有很高的百分比对他们的疾病状态有适当的认识.然而,那些部分控制/不受控制的哮喘患者对疾病的自我感知较差，强调需要进一步的病人教育。这些结论可能对其他低收入国家的哮喘患者的治疗特别有用。
