Level of Compliance with Spanish Guideline Recommendations in the Management of Asthma

IF 3.7 3区医学 Q2 ALLERGY Journal of Asthma and Allergy Pub Date : 2024-09-16 DOI:10.2147/jaa.s433291

Lorena Piñel Jimenez, Álvaro Martinez Mesa, Esther Sanchez Alvarez, Javier Lopez Garcia, Ana Aguilar Galvez, Nuria Reina Marfil, Belen Gómez Rodríguez, Eva Cabrera Cesar, Jose Luis Velasco Garrido

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Abstract

Objective: To describe the clinical management of asthmatic patients and the level of compliance with the Guía Española para el Manejo del Asma (GEMA, Spanish Guidelines for Asthma Management) in the influential al area of Virgen de la Victoria University Hospital, Málaga (Spain).
Materials and Methods: Descriptive, cross-sectional study in asthma patients from the Virgen de la Victoria University Hospital influential area, Málaga (Spain). Asthma Control Test (ACT) results, demographic and clinical characteristics, and GEMA indicators of quality asthma care were obtained from each participating patient.
Results: Two hundred and eighty-eight patients (64.2% woman, mean age 48.6 years) were included in the study. The evaluation of the level of compliance with the GEMA quality indicators showed that in 20.8% of the patients the diagnosis of asthma was confirmed by spirometry and bronchodilator test, and 52.5% of the patients with suspicion of allergic asthma performed a sensitization test. Among the smoker patients, 76.3% were recommended to stop smoking; 14.2% of the patients received a paper-based educational plan. Regarding asthma treatment, 92.3% of patients with persistent asthma received inhaled glucocorticoids (IGC). IGC and LABA were the most common treatments for asthma, used in combination (ICG + LABA) in 139 (48.3%) patients; 32.6% discontinued SABA treatment during the study period. Asthma was well controlled in 54.9% of the patients (ACT score ≥ 20), and 13.9% of the patients registered exacerbations during the previous year with a mean (SD) of 1.38 (0.74) events.
Conclusion: Most of the GEMA quality indicators of asthma care are not followed in real-world clinical practice. Specialists select the best option among the available treatments but there is an unmet need for training plans in other relevant aspects, such as diagnosis and/or disease monitoring.

Keywords: asthma, asthma control, indicators of quality care, clinical guidelines, asthma management, compliance with guidelines

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西班牙哮喘管理指南建议的合规程度

目的描述马拉加（西班牙）维多利亚圣母大学医院影响区哮喘患者的临床管理情况以及对《西班牙哮喘管理指南》（Guía Española para el Manejo del Asma，GEMA）的遵守程度：对马拉加（西班牙）维多利亚圣母大学医院影响区的哮喘患者进行描述性横断面研究。从每位参与研究的患者处获得哮喘控制测试（ACT）结果、人口统计学和临床特征以及哮喘护理质量的 GEMA 指标：研究共涉及 288 名患者（64.2% 为女性，平均年龄 48.6 岁）。对符合 GEMA 质量指标的程度进行的评估显示，20.8% 的患者通过肺活量测定和支气管扩张剂测试确诊为哮喘，52.5% 的疑似过敏性哮喘患者进行了过敏测试。在吸烟患者中，76.3%的患者被建议戒烟；14.2%的患者接受了纸质教育计划。在哮喘治疗方面，92.3%的持续性哮喘患者接受了吸入性糖皮质激素（IGC）治疗。IGC 和 LABA 是最常见的哮喘治疗方法，139 名患者（48.3%）联合使用（ICG + LABA）；32.6% 的患者在研究期间停止了 SABA 治疗。54.9%的患者哮喘得到了良好控制（ACT评分≥20），13.9%的患者在过去一年中哮喘加重，平均（标清）为1.38（0.74）次：结论：在现实世界的临床实践中，哮喘护理的大多数 GEMA 质量指标并未得到遵守。专家们在现有的治疗方法中选择了最佳方案，但在诊断和/或疾病监测等其他相关方面的培训计划需求尚未得到满足。

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来源期刊

Journal of Asthma and Allergy Medicine-Immunology and Allergy

CiteScore

5.30

自引率

6.20%

发文量

185

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies. Although the main focus of the journal will be to publish research and clinical results in humans, preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies.