通过多部门合作优化中低收入国家的哮喘护理:第一届菲律宾哮喘大会的建议报告。

Expert review of respiratory medicine Pub Date : 2024-12-01 Epub Date: 2024-12-10 DOI:10.1080/17476348.2024.2389948
Lenora Fernandez, Helen K Reddel, Dina Diaz, Camilo Roa, Ricardo Zotomayor, Josephine Ramos, Gregorio Ocampo, Maria Victoria Cruz, Rommel Punongbayan
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引用次数: 0

摘要

哮喘是最常见的非传染性疾病之一,引起了全球对哮喘相关死亡的严重关注。研究报告了短效β激动剂(SABAs)单药治疗的安全性问题。SABA的过度使用严重加重了菲律宾的医疗负担。尽管全球哮喘网络多年来一直倡导以可负担的价格平等获得高质量的基本药物,但包括菲律宾在内的大多数低收入和中等收入国家对国际卫生保健政策的采用有限。涵盖的领域:我们回顾了针对哮喘患病率和哮喘相关死亡率、SABA过度依赖及其不良事件、SABA替代方案、患者转诊和MDT哮喘治疗方法的非系统文献检索的综合。在这里,我们描述了通过持续的多部门合作改善哮喘护理的区域挑战和建议。专家意见:使用吸入糖皮质类固醇-福莫特罗联合用药可能有助于减少不良事件,包括严重恶化、住院、口服糖皮质类固醇引起的并发症和长期治疗费用。提高患者对预防措施、适当的吸入器技术和药物依从性的认识可以减轻不受控制的哮喘的负担。此外,改善哮喘药物的可及性,制定治疗算法和转诊途径,包括为初级保健医生建立多学科团队,将为包括菲律宾在内的中低收入国家提供最佳哮喘治疗铺平道路。
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Optimizing asthma care in low-to-middle income countries through multisectoral collaboration: recommendation report of the first Philippine Asthma Assembly.

Introduction: Asthma is one of the most common noncommunicable diseases, raising serious concerns about asthma-related deaths globally. Studies have reported safety concerns with short-acting beta-agonists (SABAs) monotherapy. SABA overuse contributes significantly to the healthcare burden in the Philippines. Despite Global Asthma Network's years-long advocacy for equal access to essential medicines at affordable cost, the uptake of international healthcare policies is limited in most low- and middle-income countries, including the Philippines.

Areas covered: We reviewed synthesis of targeted nonsystematic literature searches on prevalence of asthma and asthma-related mortality, SABA overreliance and its adverse events, alternatives to SABA, patient referral, and multidisciplinary team (MDT) approach for asthma management. We describe regional challenges and recommendations for improving asthma care through continued multisectoral collaboration.

Expert opinion: Use of medications like inhaled corticosteroid-formoterol combinations may aid in reducing adverse events including severe exacerbations, hospitalizations, complications from oral corticosteroid use, and long-term treatment costs. Raising patient awareness about preventive measures, proper inhaler techniques, and medication adherence can mitigate burden of uncontrolled asthma. Improving access to asthma medications alongside developing treatment algorithms and referral pathways (including MDT) for primary care physicians will pave the way for optimal asthma care in LMICs, including the Philippines.

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