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首页> 外文期刊>Journal of the American Pharmaceutical Association: APhA >Improving drug therapy for patients with asthma-part 2: Use of antiasthma medications.
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Improving drug therapy for patients with asthma-part 2: Use of antiasthma medications.

机译：改善哮喘患者的药物治疗-第2部分：使用抗哮喘药。

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OBJECTIVES: To describe the use of antiasthma drugs among the study patients and to evaluate whether therapeutic outcomes monitoring (TOM) is associated with improved quality of drug therapy. DESIGN: Prospective, controlled, multicenter study. Consumption of antiasthma medications was measured as the number of defined daily doses (DDDs) purchased. Data were collected from the pharmacies' computer systems for a period beginning 6 months before the start of the study (period 1) and during its first and second half-years (periods 2 and 3). Treatment changes for TOM patients were classified on the basis of drug regimens at periods 1 and 3. SETTING: Community pharmacies in Denmark (16 intervention, 15 control). PATIENTS: Five hundred patients with asthma aged 16 to 60 years who were being treated in primary health care; this study used data from 350 patients from this sample. INTERVENTION: TOM. MAIN OUTCOME MEASURES: Changes in the use of individual drugs and changes in therapeutic patterns--distribution ofpurchased drugs; proportion of corticosteroid users; frequency of drug regimens used; treatment changes for TOM patients. RESULTS: TOM patients' consumption of beta2-agonists decreased by 12% overall from period 1 through period 3, while control patients' consumption of these medications decreased by only 1%. TOM patients' use of inhaled corticosteroids increased by more than 50% compared with 9% among controls. In both groups, about one-half of all purchased DDDs were for inhaled beta2-agonists. The proportion of inhaled corticosteroids increased from 27% to 42% of total DDDs for the TOM group and remained constant for controls. Of patients using beta2-agonists, 68% also used inhaled steroids initially in both the TOM and control groups. The proportion of inhaled steroid users in the TOM group increased to 84%, and to 70% among controls. The most common regimen was inhaled short-acting beta2-agonists and corticosteroids in combination, and the second most common regimen was monotherapy with short-acting beta2-agonists. With time, the regimens changed more toward consensus guidelines among TOM patients. Changes in drug therapy totaled 451, averaging 2.4 changes per TOM patient. The largest number of changes (49%) involved inhaled corticosteroids. CONCLUSION: Changes in medication use among TOM patients were toward improved asthma treatment. Our results show that community pharmacists, physicians, and patients, working together, can improve prescribing, solve drug therapy problems, and improve outcomes for patients with moderate-to-severe asthma.
机译：目的：描述研究对象中抗哮喘药物的使用，并评估治疗效果监测（TOM）是否与改善药物治疗质量有关。设计：前瞻性，对照，多中心研究。抗哮喘药物的消耗量按购买的规定每日剂量（DDD）的数量来衡量。在研究开始前的6个月（期间1）以及研究的前半年和下半年（期间2和3）期间，从药房的计算机系统收集了数据。根据第1和第3阶段的药物治疗方案，对TOM患者的治疗变化进行分类。地点：丹麦的社区药房（16种干预措施，15种对照）。患者：500名年龄在16至60岁之间的哮喘患者正在接受初级卫生保健;这项研究使用了来自该样本的350位患者的数据。干预：汤姆。主要观察指标：使用个别药物和治疗方式发生变化-购买药物的分布;皮质类固醇使用者的比例;使用药物方案的频率; TOM患者的治疗改变。结果：从第1阶段到第3阶段，TOM患者的β2受体激动剂总体减少了12％，而对照组患者的这些药物的消耗仅减少了1％。 TOM患者吸入皮质类固醇的使用增加了50％以上，而对照组为9％。在两组中，所有购买的DDD中约有一半用于吸入β2-激动剂。 TOM组吸入皮质类固醇的比例从总DDDs的27％增加到42％，而对照组则保持不变。在使用β2受体激动剂的患者中，有68％的患者最初在TOM和对照组中也使用了吸入类固醇。 TOM组中吸入类固醇使用者的比例增加到84％，在对照组中增加到70％。最常见的方案是吸入短效β2受体激动剂和皮质类固醇合用，第二常见的方案是短效β2受体激动剂的单药治疗。随着时间的推移，TOM患者的治疗方案朝着共识指南的方向转变。药物治疗变更总计451，平均每位TOM患者变更2.4。吸入皮质类固醇激素的变化最大（49％）。结论：TOM患者的用药变化是为了改善哮喘治疗。我们的结果表明，社区药剂师，医生和患者一起工作可以改善处方，解决药物治疗问题，并改善中度至重度哮喘患者的预后。

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