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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Adherence feedback to improve asthma outcomes among inner-city children: a randomized trial.
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Adherence feedback to improve asthma outcomes among inner-city children: a randomized trial.

机译：坚持反馈可改善内城区儿童的哮喘预后：一项随机试验。

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OBJECTIVE: We evaluated the longitudinal effects of home-based asthma education combined with medication adherence feedback (adherence monitoring with feedback [AMF]) and asthma education alone (asthma basic care [ABC]) on asthma outcomes, relative to a usual-care (UC) control group. METHODS: A total of 250 inner-city children with asthma (mean age: 7 years; 62% male; 98% black) were recruited from a pediatric emergency department (ED). Health-outcome measures included caregiver-frequency of asthma symptoms, ED visits, hospitalizations, and courses of oral corticosteroids at baseline and 6-, 12-, and 18-month assessments. Adherence measures included caregiver-reported adherence to inhaled corticosteroid (ICS) therapy and pharmacy records of ICS refills. Multilevel modeling was used to examine the differential effects of AMF and ABC compared with UC. RESULTS: ED visits decreased more rapidly for the AMF group than for the UC group, but no difference was found between the ABC and UC groups. The AMF intervention led to short-term improvements in ICS adherence during the active-intervention phase relative to UC, but this improvement decreased over time. Asthma symptoms and courses of corticosteroids decreased more rapidly for the ABC group than for the UC group. Hospitalization rates did not differ between either intervention group and the UC group. No differences were found between the ABC and AMF groups on any outcome. CONCLUSIONS: Asthma education led to improved adherence and decreased morbidity compared with UC. Home-based educational interventions may lead to modest short-term improvements in asthma outcomes among inner-city children. Adherence feedback did not improve outcomes over education alone.
机译：目的：我们评估了家庭哮喘教育，药物依从性反馈（依从性监测与反馈[AMF]）和单纯哮喘教育（哮喘基本护理[ABC]）相较于常规护理相对于哮喘的纵向影响UC）对照组。方法：从小儿急诊科（ED）招募了250名市区哮喘儿童（平均年龄：7岁;男性62％;黑人98％）。健康结果指标包括照料者的哮喘症状发生频率，急诊就诊，住院以及基线和6、12、18个月评估时口服糖皮质激素的疗程。依从性措施包括护理人员报告的依从性对吸入皮质类固醇（ICS）疗法的依从性以及ICS补充剂的药房记录。使用多级建模来检查AMF和ABC与UC的差异效果。结果：AMF组的ED访问减少比UC组更快，但是ABC和UC组之间没有发现差异。相对于UC，AMF干预在主动干预阶段导致了ICS依从性的短期改善，但随着时间的推移，这种改善有所降低。与UC组相比，ABC组的哮喘症状和皮质类固醇激素的病程下降更快。干预组和UC组之间的住院率没有差异。 ABC组和AMF组之间在任何结局上均未发现差异。结论：与UC相比，哮喘教育可提高依从性并降低发病率。基于家庭的教育干预措施可能会导致内城区儿童哮喘预后的短期改善。坚持反馈并不能单独提高教育效果。

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