Effectiveness of strengthening management in bronchial asthma control among community patients / 中华全科医师杂志

ABSTRACT

Objective:To evaluate the effectiveness of strengthening management in the bronchial asthma control among community patients.Methods:One hundred and eighteen community patients with bronchial asthma were recruited from January 2017 to January 2018. The patients were divided into community strengthening management group ( n=60) and control group ( n=58), the annual times of acute attack, time to first exacerbation and annual medical expenses were compared between the two groups. The proportion of inhaled corticosteroid (ICS) administration was documented; the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), Leicester Cough Questionnaire (LCQ), Fractional exhaled nitric oxide(FeNO) and pulmonary function were evaluated in two groups. Results:The management group had greater improvements in the proportion of ICS administration [45(75.0%) vs.36(62.1%), χ 2=4.143], ACT [(20.7±3.9) vs.(18.1±4.1), t=3.213], LCQ [(13.5±5.3) vs.(10.8±3.0), t=2.603], FeNO [(29.8±12.8) vs. (37.1±11.1), t=2.018] than the control group after six months of management (all P<0.05). There were significantly greater improvements in proportion of ICS treating [50(83.3%) vs. 34(58.6%), χ 2=5.748], ACT [(22.1±2.8) vs. (19.5±2.3), t=2.241], LCQ [(16.5±4.2) vs. (11.6±3.2),=5.603], miniAQLQ [(83.2±11.1) vs.(68.1±13.3), t=3.186] and FeNO [(28.2±13.1) vs.(38.1±16.3), t=2.176] in management group than those in control group after one year of management (all P<0.05); but no differences were seen in FEV 1%, FVC%, FEV 1/FVC (all P>0.05) between two groups. The LCQ score [(16.5±4.2) vs. (13.5±5.3), t=3.186] and the MiniAQLQ score [(83.2±11.1) vs. (69.1±14.3), t=5.603] of the management group were significantly improved after 1 year of management than those after 6 months. There was significant improvement in time to first exacerbation [182(92, 284) vs. 92(58, 176), Z=4.384] and the annual exacerbation was significantly reduced [0(0, 1) vs. 2(1, 3), Z=-3.187], annual medical costs of management group were significantly lower than those of control group [(10 523.0±550.5)Yuan vs. (15 787.1±1 421.2)Yuan, t=2.653]. Conclusion:The strengthening management can effectively improve the control rate of bronchial asthma, reduce acute exacerbation, improve clinical symptoms and improve the quality of life in community patients with bronchial asthma.