Willingness of patients to perform self-management of asthma and the role of inhaled steroids

患者自我管理哮喘的意愿及吸入性糖皮质激素的作用

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Abstract

OBJECTIVE: Asthma self-management is a generally accepted effective treatment strategy for asthma patients. Acceptance by patients may be a barrier for successful implementation. In this study the role of inhaled steroids in starting asthma self-management is described. DESIGN: Cross-sectional explorative study. SETTING: General Practice. SUBJECTS: 283 adult steroid requiring asthma patients were invited by their GP to participate in a self-management program. MAIN OUTCOME MEASURES: In a multivariate logistic regression model the relation between baseline dosage of inhaled steroids, occupational status, age and sex as independent and willingness to participate as dependent variables was explored. RESULTS: Of all invited, 148 (52%) were willing to participate. Subjects not using inhaled steroids were least willing to participate (43/143 = 30%). Subjects with low doses of inhaled steroids (<400 mcg daily) were most willing to participate (44/54 = 81%). Unemployed asthmatics had a higher tendency to participate than patients with a regular job. CONCLUSION: Acceptance of self-management by patients is not a limiting issue in promoting self-management of asthma in general practice. High acceptance in patients using low or intermediate doses of inhaled steroids makes general practice the most appropriate setting for self management. A selection procedure is recommended.

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