通过 Elpenhaler® 设备接受沙美特罗/氟替卡松治疗的慢性阻塞性肺病患者的治疗依从性和健康状况:AHEAD研究。

IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-07-26 DOI:10.1111/crj.13803
Konstantinos P. Exarchos, Georgios Hillas, Paschalis Steiropoulos, Polyanthi Papanastasiou, Athena Gogali, Konstantinos Kostikas
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引用次数: 0

摘要

背景:慢性阻塞性肺疾病(COPD)是一种以长期呼吸道症状和气流受限为特征的异质性进行性肺部疾病。适当的支气管扩张是慢性阻塞性肺病治疗的基石,可改善患者的健康状况,改善预后,降低死亡率:在本项开放性、非干预性、观察性研究中,716 名严重程度不等的慢性阻塞性肺病患者通过 Elpenhaler® 设备接受了丙酸氟替卡松和沙美特罗(500 + 50 mcg)的固定剂量复合制剂(FDC)治疗。在研究开始时和 3 个月的随访期结束时,对患者的治疗依从性(基于 MMAS-8 [8 项莫里斯基用药依从性量表])和健康状况(基于 CCQ [临床慢性阻塞性肺病问卷])进行了评估:随访1个月和3个月时,MMAS-8评分的平均值(± SD)分别为6.12±1.89和6.45±1.80,表明总体依从性中等;但随访结束时,MMAS-8评分在统计学上显著增加了0.33个单位(配对t检验P 结论:氟丁胺口服溶液(FDC)的治疗效果显著:通过 Elpenhaler® 设备服用丙酸氟替卡松和沙美特罗(500 + 50 微克)的 FDC 治疗慢性阻塞性肺疾病,治疗依从性保持良好或略有提高,健康状况随之改善,并在治疗 3 个月后继续保持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Treatment Adherence and Health Status of Patients With COPD Under Treatment With Salmeterol/Fluticasone via the Elpenhaler® Device: The AHEAD Study

Background

Chronic obstructive pulmonary disease (COPD) is a heterogeneous progressive lung condition characterized by long-term respiratory symptoms and airflow limitation. Appropriate bronchodilation is the cornerstone of COPD treatment, leading to better health status as well as benefits in prognosis and mortality.

Methods

In the current open, noninterventional, observational study, 716 patients diagnosed with COPD of variable severity were administered a fixed-dose combination (FDC) of fluticasone propionate and salmeterol (500 + 50 mcg) through the Elpenhaler® device. The patients' adherence to treatment (based on the MMAS-8 [8-item Morisky Medication Adherence Scale]) and health status (based on the CCQ [Clinical COPD Questionnaire]) were assessed at the beginning of the study and at the end of the 3-month follow-up period.

Results

The mean ± SD MMAS-8 score at 1 and 3 months was 6.12 ± 1.89 and 6.45 ± 1.80, respectively, indicating medium adherence overall; however, there was a statistically significant increase of 0.33 units in the MMAS-8 score at the end of the follow-up (paired t-test p < 0.0001), suggestive of an improvement in adherence throughout the study. Higher adherence was associated with better health status at baseline, which further improved by the end of the follow-up. Moreover, we observed a statistically significant decrease of 1.07 points (p < 0.0001) in the mean CCQ total score from the baseline (CCQ score = 2.2 ± 1.00) until the end of the study follow-up (CCQ score = 1.13 ± 0.67). Similar conclusions were also drawn in the mean domain scores regarding symptoms (score equal to 1.36 ± 0.72, decrease by 1.18) as well as functional and mental state (scores equal to 0.86 ± 0.73 and 1.20 ± 0.88, decrease by 1.04 and 1.00, respectively, p < 0.0001). Similarly, when patients were stratified into subgroups with and without comorbidities, the former group showed an increase of 7% in the patients with medium to high adherence during the course of the study. In the same patient subgroup, there was a notable decrease in CCQ score by 1.18 points (p < 0.0001) during the study.

Conclusions

The administration of FDC of fluticasone propionate and salmeterol, (500 + 50 mcg) via the Elpenhaler® device for COPD, resulted in a well-maintained or slight increase in treatment adherence and a subsequent benefit in health status, which further persisted after 3 months of treatment.

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来源期刊
Clinical Respiratory Journal
Clinical Respiratory Journal 医学-呼吸系统
CiteScore
3.70
自引率
0.00%
发文量
104
审稿时长
>12 weeks
期刊介绍: Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)
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