Araştırma Makalesi
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Birinci basamakta astım kontrolü: Kesitsel çalışma

Yıl 2016, Cilt: 1 Sayı: 2, 53 - 57, 30.08.2016
https://doi.org/10.22391/920.256693

Öz

Giriş: Günümüzde astım tedavisi kontrol odaklı olmakla birlikte astım kontrolü, astım belirtilerinin ne derece azaldığı ve tedavinin amacına ulaşıp ulaşmadığını ifade eden bir terim olarak kullanılmaktadır. Astım kontrolü dünyada ve ülkemizde istenen düzeyde değildir. Bu çalışmanın amacı birinci basamakta astım hastalarının kontrol düzeyini değerlendirmek ve hastaları astım konusunda bilinçlendirmektir.

Yöntem: Araştırma kesitsel tanımlayıcı tipte olup araştırma evreni Karaman Sarıveliler İlçe Entegre Hastanesine başvuran astım hastalarından oluşmaktadır. Hastalara araştırmacı tarafından yüz yüze görüşme yöntemi ile sosyodemografik özelliklerin sorgulandığı 19 soruluk bir anket ile birlikte Astım Kontrol Testi (AKT) ve Astım Kontrol Ölçeği (ACQ) uygulandı. Çalışmada elde edilen veriler SPSS 16,0 programı ile istatistiksel olarak analiz edildi. Sayısal değerler sürekli ve kesikli numerik değerler biçiminde ve yüzdelerle belirtildi. Sonuçlar %95 güven aralığında, p<0.05 anlamlılık düzeyinde değerlendirildi.

Bulgular: Çalışmaya katılan hastaların AKT puanı ortalama 12,89, ACQ puanı ise 14,86 idi. %30 hastanın astıma ek olarak sadece hipertansiyonu varken %18 hastanın ek başka bir hastalığı yoktu. Hastaların %91’i(n=91) kontrol altında değilken %9’u (n=9) kısmi kontrol altındaydı. Tam kontrol altında olan hasta yoktu. Kadınların %94,9’u, erkeklerin ise %76,2’si kontrol altında değildi. Cinsiyet, meslek ve sigara kullanımı ile kontrol durumu arasında istatistiksel açıdan fark bulundu.  Diğer sosyodemografik özelliklerin kontrol durumunu etkilemediği saptandı.

Sonuç: Astım ülkemizde prevalansı yüksek olan kronik hastalıklardan biri olup hastalığın kontrolü oldukça önemlidir. Bu açıdan hastaların ilk görüldüğü yer olan birinci basamakta hastalar hekimler tarafından basit bir test olan AKT ile değerlendirilmeli ve gerekli görülürse diğer basamaklara yönlendirilmelidir.

Kaynakça

  • Müftüoğlu E. (Ed.). Güncel Tıbbi Tanı&Tedavi. Lange 2010. 49. Baskı. p: 216.
  • Bozdemir N., Kara İH. (Eds.). Birinci Basamakta Tanı ve Tedavi. Adana Nobel Kitabevi.2010. p: 554.
  • Global strategy for asthma management and prevention. WHO/NHLBI workshop report. Revised2002.
  • Global strategy for asthma management and prevention. WHO/NHLBI workshop report. Revised2006.
  • Guidelines for the Diagnosis and Management of Asthma (EPR-3). National Institues of Health Pub. No: 08-4051, Bethesda, MD, 2007. http://www.nhlbi.nih.gov/files/docs/guidelines/04_sec3_comp.pdf
  • Corrado A, Renda T, Polese G, Rossi A; SERENA (Studio ossERvazionalE per il monitoraggio dell'asma non coNtrollAto)/AIPO StudyGroup. Assessment of asthma control: the SERENA study. RespirMed. 2013 Nov; 107(11):1659-66.
  • Zemedkun K, Woldemichael K, Tefera G. Assessing control of asthma in jush, jimma, Southwest Ethiopia. Ethiop J HealthSci. 2014 Jan; 24(1):49-58.
  • Skorup P, Rizzo LV, Machado-Boman L, Janson C. Asthma management and asthma control in SãoPaulo, Braziland Uppsala, Sweden: a questionnaire-based comparison. Clin Respir J. 2009 Jan; 3(1):22-8.
  • 9.Benkheder A, Bouacha H, Nafti S, Taright S, El Ftouh M, Yassine N, Fakhfakh H, Ali-Khoudja M, Texier N, El Hasnaoui A. Control of asthma in the Maghreb: results of the AIRMAG study. RespirMed. 2009 Dec; 103 Suppl 2:S12-20.
  • Turktas H, Mungan D, Uysal MA, Oguzulgen K; Turkish Asthma Control Survey Study Group. Determinants of asthma control in tertiary level in Turkey: a cross-sectional multicenter survey. J Asthma. 2010 Jun; 47(5):557-62.
  • Bozbaş ŞS, Özyürek BA, Ulubay G. Astımda Hastalık Kontrolü ile Demografik Özellikler, Yaşam Kalitesi ve Emosyonel Durumun İlişkisi. Tur Toraks Der 2011; 12: 139-44.
  • Abadoğlu Ö. Astım Kontrolünü Değerlendirme Anketleri. Astım Allerji İmmünoloji 2008; 6(2):99-104.
  • Ko FW, Leung TF, Hui DS, Chu HY, Wong GW, Wong E, Tung AH, Lai CK. Asthma Control Test correlates well with the treatment decisions made by asthma specialists. Respirology. 2009 May; 14(4):559-66.
  • Ställberg B, Lisspers K, Hasselgren M, Janson C, Johansson G, Svärdsudd K. Asthma control in primary care in Sweden: a comparison between 2001 and 2005. Prim Care Respir J. 2009 Dec; 18(4):279-86.
  • Al-Zahrani JM, Ahmad A, AL-Harbi A, Khan AM, Al-Bader B, Baharoon S,AL Shememeri A, Al-Jahdali H. Factors associated with poor asthma control in the outpatient clinic setting. Ann Thorac Med. 2015 Apr-Jun; 10(2): 100–104.
  • Mintz M, Gilsenan AW, Bui CL, Ziemiecki R, Stanford RH, William Lincourt W, Ortega H. Assessment of asthma control in primary care. Current Medical Research & Opinion, October 2009, Vol. 25, No. 10: 2523-2531.
  • Hayat E, Börekçi Ş, Gemicioğlu B. Reflux, Allergic Rhinitis, and Sleep Disorders with Asthma Control and Quality of Life. J Clin Anal Med 2014; 5(6): 453-6.
  • Desalu OO1, Fawibe AE, Salami AK. Assessment of the level of asthma control among adult patients in two tertiary care centers in Nigeria. J Asthma. 2012 Sep; 49(7):765-72.
  • Dales RE, Spitzer WO, Schechter MT, Suissa S. The influence of psychological status on respiratory symptom reporting. Am Rev RespirDis 1989; 139:1459-63.
  • Plaza, V., Sanchis, J.: Medical personel and patient skill in the use of metered dose inhalers: a multicentric study. CESEA Group, Respiration, 65(3), 195-198, (1998).
  • Shrestha, M., Parupia, H., Andrews, B., Kim, S.W., Martin, M.S., Park, D.I., Gee, E.: Metered-dose inhaler technique of patients in an urban ED: prevalence of incorrect technique and attempt at education, Am J Emerg Med, 14(4), 380-384, (1996).
  • Chapman, K.R., Love, L., Brubaker, H.: A comparison of breath-actuate dand convention almetered-dose inhaler inhalation techniques in elderly subjects, Chest, 104(5), 1332-1337, (1993).
  • Brocklebank, D., Ram, F., Wright, J., Barry, P., Cates, C., Davies, L., Douglas, G., Muers, M., Smith, D., White, J.: Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature, Health Technol Assess, 5(26), 1-149, (2001).
  • Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability, EurRespir J, 19(2), 246-251, (2002).
  • Van der Palen, J.,Klein, J.J., Kerkhoff, A.H., van Herwaarden, C.L.: Evaluation of the effectiveness of four different inhalers in patients with chronic obstructive pulmonary disease, Thorax, 50(11), 1183-1187, (1995).
  • Everard, M.L.: Role of inhaler competence and contrivance in "difficult asthma", Paediatr Respir Rev, 4(2), 135-142, (2003).

Control of asthma in primary care: a cross sectional study

Yıl 2016, Cilt: 1 Sayı: 2, 53 - 57, 30.08.2016
https://doi.org/10.22391/920.256693

Öz

Introduction: Nowadays asthma treatment is focused on control. Asthma control is used as a term to express the reduction of asthma signs and the goal of treatment. Asthma control is not at the desired level in the world and in our country. The aim of this study is to assess the level of asthma control in primary care and to raise awareness about asthma.

Methods: The universe of research consists of asthma patients admitted to Karaman Sarıveliler State Integrated Hospital. The researcher conducted face-to-face interview using 19-item questionnaire asking demographic features, Asthma Control Test (ACT) and the Asthma Control Questionnaire (ACQ). This clinical research is a cross sectional descriptive study and SPSS for Windows Version 16.0 was used for statistical evaluations. The numerical values indicated in the form of continuous and discrete numeric values and percentage. Results were evaluated in 95% confidence interval, p<0.05 was accepted as the value for statistical significance.

Results: The average ACT score was 12.89, and the ACQ score was 14.86. 30% of patients had hypertension with asthma while 18% of patients had no additional disease. 91% of patients (n= 91) is not under control, and 9% (n= 9) was partially under control. There was no patient under full control. 94.9% of women and 76.2% of men were not under control. A statistically significant difference was found between the control status and gender, profession, tobacco use. It was found that other demographic factors had no effect on the control of asthma.

Conclusion: Asthma is one of the chronic diseases which have high prevalence in our country. So asthma control is very important. In this regard, patients should be evaluated by a simple test like ACT in the primary care and if necessary they should be referred to the secondary care by the physician.

Kaynakça

  • Müftüoğlu E. (Ed.). Güncel Tıbbi Tanı&Tedavi. Lange 2010. 49. Baskı. p: 216.
  • Bozdemir N., Kara İH. (Eds.). Birinci Basamakta Tanı ve Tedavi. Adana Nobel Kitabevi.2010. p: 554.
  • Global strategy for asthma management and prevention. WHO/NHLBI workshop report. Revised2002.
  • Global strategy for asthma management and prevention. WHO/NHLBI workshop report. Revised2006.
  • Guidelines for the Diagnosis and Management of Asthma (EPR-3). National Institues of Health Pub. No: 08-4051, Bethesda, MD, 2007. http://www.nhlbi.nih.gov/files/docs/guidelines/04_sec3_comp.pdf
  • Corrado A, Renda T, Polese G, Rossi A; SERENA (Studio ossERvazionalE per il monitoraggio dell'asma non coNtrollAto)/AIPO StudyGroup. Assessment of asthma control: the SERENA study. RespirMed. 2013 Nov; 107(11):1659-66.
  • Zemedkun K, Woldemichael K, Tefera G. Assessing control of asthma in jush, jimma, Southwest Ethiopia. Ethiop J HealthSci. 2014 Jan; 24(1):49-58.
  • Skorup P, Rizzo LV, Machado-Boman L, Janson C. Asthma management and asthma control in SãoPaulo, Braziland Uppsala, Sweden: a questionnaire-based comparison. Clin Respir J. 2009 Jan; 3(1):22-8.
  • 9.Benkheder A, Bouacha H, Nafti S, Taright S, El Ftouh M, Yassine N, Fakhfakh H, Ali-Khoudja M, Texier N, El Hasnaoui A. Control of asthma in the Maghreb: results of the AIRMAG study. RespirMed. 2009 Dec; 103 Suppl 2:S12-20.
  • Turktas H, Mungan D, Uysal MA, Oguzulgen K; Turkish Asthma Control Survey Study Group. Determinants of asthma control in tertiary level in Turkey: a cross-sectional multicenter survey. J Asthma. 2010 Jun; 47(5):557-62.
  • Bozbaş ŞS, Özyürek BA, Ulubay G. Astımda Hastalık Kontrolü ile Demografik Özellikler, Yaşam Kalitesi ve Emosyonel Durumun İlişkisi. Tur Toraks Der 2011; 12: 139-44.
  • Abadoğlu Ö. Astım Kontrolünü Değerlendirme Anketleri. Astım Allerji İmmünoloji 2008; 6(2):99-104.
  • Ko FW, Leung TF, Hui DS, Chu HY, Wong GW, Wong E, Tung AH, Lai CK. Asthma Control Test correlates well with the treatment decisions made by asthma specialists. Respirology. 2009 May; 14(4):559-66.
  • Ställberg B, Lisspers K, Hasselgren M, Janson C, Johansson G, Svärdsudd K. Asthma control in primary care in Sweden: a comparison between 2001 and 2005. Prim Care Respir J. 2009 Dec; 18(4):279-86.
  • Al-Zahrani JM, Ahmad A, AL-Harbi A, Khan AM, Al-Bader B, Baharoon S,AL Shememeri A, Al-Jahdali H. Factors associated with poor asthma control in the outpatient clinic setting. Ann Thorac Med. 2015 Apr-Jun; 10(2): 100–104.
  • Mintz M, Gilsenan AW, Bui CL, Ziemiecki R, Stanford RH, William Lincourt W, Ortega H. Assessment of asthma control in primary care. Current Medical Research & Opinion, October 2009, Vol. 25, No. 10: 2523-2531.
  • Hayat E, Börekçi Ş, Gemicioğlu B. Reflux, Allergic Rhinitis, and Sleep Disorders with Asthma Control and Quality of Life. J Clin Anal Med 2014; 5(6): 453-6.
  • Desalu OO1, Fawibe AE, Salami AK. Assessment of the level of asthma control among adult patients in two tertiary care centers in Nigeria. J Asthma. 2012 Sep; 49(7):765-72.
  • Dales RE, Spitzer WO, Schechter MT, Suissa S. The influence of psychological status on respiratory symptom reporting. Am Rev RespirDis 1989; 139:1459-63.
  • Plaza, V., Sanchis, J.: Medical personel and patient skill in the use of metered dose inhalers: a multicentric study. CESEA Group, Respiration, 65(3), 195-198, (1998).
  • Shrestha, M., Parupia, H., Andrews, B., Kim, S.W., Martin, M.S., Park, D.I., Gee, E.: Metered-dose inhaler technique of patients in an urban ED: prevalence of incorrect technique and attempt at education, Am J Emerg Med, 14(4), 380-384, (1996).
  • Chapman, K.R., Love, L., Brubaker, H.: A comparison of breath-actuate dand convention almetered-dose inhaler inhalation techniques in elderly subjects, Chest, 104(5), 1332-1337, (1993).
  • Brocklebank, D., Ram, F., Wright, J., Barry, P., Cates, C., Davies, L., Douglas, G., Muers, M., Smith, D., White, J.: Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature, Health Technol Assess, 5(26), 1-149, (2001).
  • Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability, EurRespir J, 19(2), 246-251, (2002).
  • Van der Palen, J.,Klein, J.J., Kerkhoff, A.H., van Herwaarden, C.L.: Evaluation of the effectiveness of four different inhalers in patients with chronic obstructive pulmonary disease, Thorax, 50(11), 1183-1187, (1995).
  • Everard, M.L.: Role of inhaler competence and contrivance in "difficult asthma", Paediatr Respir Rev, 4(2), 135-142, (2003).
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Raziye Şule Gümüştakım

Hilal Deşik Aksoy

Yayımlanma Tarihi 30 Ağustos 2016
Gönderilme Tarihi 28 Haziran 2016
Kabul Tarihi 21 Eylül 2016
Yayımlandığı Sayı Yıl 2016Cilt: 1 Sayı: 2

Kaynak Göster

APA Gümüştakım, R. Ş., & Deşik Aksoy, H. (2016). Control of asthma in primary care: a cross sectional study. Family Practice and Palliative Care, 1(2), 53-57. https://doi.org/10.22391/920.256693
AMA Gümüştakım RŞ, Deşik Aksoy H. Control of asthma in primary care: a cross sectional study. Fam Pract Palliat Care. Ağustos 2016;1(2):53-57. doi:10.22391/920.256693
Chicago Gümüştakım, Raziye Şule, ve Hilal Deşik Aksoy. “Control of Asthma in Primary Care: A Cross Sectional Study”. Family Practice and Palliative Care 1, sy. 2 (Ağustos 2016): 53-57. https://doi.org/10.22391/920.256693.
EndNote Gümüştakım RŞ, Deşik Aksoy H (01 Ağustos 2016) Control of asthma in primary care: a cross sectional study. Family Practice and Palliative Care 1 2 53–57.
IEEE R. Ş. Gümüştakım ve H. Deşik Aksoy, “Control of asthma in primary care: a cross sectional study”, Fam Pract Palliat Care, c. 1, sy. 2, ss. 53–57, 2016, doi: 10.22391/920.256693.
ISNAD Gümüştakım, Raziye Şule - Deşik Aksoy, Hilal. “Control of Asthma in Primary Care: A Cross Sectional Study”. Family Practice and Palliative Care 1/2 (Ağustos 2016), 53-57. https://doi.org/10.22391/920.256693.
JAMA Gümüştakım RŞ, Deşik Aksoy H. Control of asthma in primary care: a cross sectional study. Fam Pract Palliat Care. 2016;1:53–57.
MLA Gümüştakım, Raziye Şule ve Hilal Deşik Aksoy. “Control of Asthma in Primary Care: A Cross Sectional Study”. Family Practice and Palliative Care, c. 1, sy. 2, 2016, ss. 53-57, doi:10.22391/920.256693.
Vancouver Gümüştakım RŞ, Deşik Aksoy H. Control of asthma in primary care: a cross sectional study. Fam Pract Palliat Care. 2016;1(2):53-7.

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505