Influencing factors of inhaled medication compliance in Chinese asthma patients: a meta-analysis_West China Medical Journal

Authors：

QIN Fujia ,  CUI Miaoling , NONG Ying , LI Yan

Nursing Department, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 532100, P. R. China;

Corresponding author：

CUI Miaoling, Email: cuimiaoling@126.com

Keywords：

Asthma; inhaled dosing; compliance; influencing factors; meta-analysis

DOI：

10.7507/1002-0179.202005098

Video：

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Objective To explore the influencing factors of inhalation medication compliance in Chinese asthma patients, and to provide evidence for improving the compliance of patients with inhalation therapy. Methods PubMed, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were searched for literature on factors influencing inhalation medication compliance in Chinese asthma patients from the establishment of databases to December 2021. Meta-analysis was performed using RevMan 5.2 software. Results A total of 16 studies were included, with a sample size of 2 600 cases, 1 084 cases of good compliance with inhalation administration, 1 516 cases of poor compliance with inhalation administration, and good compliance with inhalation administration accounted for 41.69%. The literature quality evaluation scores were all ≥4 points, all of which were of medium quality and above. Meta-analysis showed that the factors affecting inhalation compliance of asthma patients included age [odds ratio (OR)=0.54, 95% confidence interval (CI) (0.32, 0.91), P=0.02], educational level [OR=0.57, 95%CI (0.36, 0.90), P=0.02], doctor-patient relationship [OR=0.42, 95%CI (0.19, 0.93), P=0.03], disease severity [OR=0.25, 95%CI (0.11, 0.58), P=0.001], degree of mastery of asthma knowledge [OR=2.51, 95%CI (1.11, 5.65), P=0.03], degree of mastery of inhalation technique [OR=8.66, 95%CI (3.20, 23.40), P<0.0001], adverse drug reaction [OR=0.23, 95%CI (0.13, 0.41), P<0.00001]. Conclusion The compliance of inhaled dosing in Chinese asthma patients needs to be improved urgently. Age, education level, doctor-patient relationship, disease severity, mastery of asthma knowledge, mastery of inhalation technology, and adverse drug reactions are the important influencing factors of inhaled medication compliance.

Citation： QIN Fujia, CUI Miaoling, NONG Ying, LI Yan. Influencing factors of inhaled medication compliance in Chinese asthma patients: a meta-analysis. West China Medical Journal, 2022, 37(6): 893-901. doi: 10.7507/1002-0179.202005098 Copy

1.	Huang K, Yang T, Xu J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet, 2019, 394(10196): 407-418.
2.	中华医学会呼吸病学分会哮喘学组. 支气管哮喘患者自我管理中国专家共识. 中华结核和呼吸杂志, 2018, 41(3): 171-178.
3.	林江涛, 王文巧, 周新, 等. 我国 30 个省市城区门诊支气管哮喘患者控制水平的调查结果. 中华结核和呼吸杂志, 2017, 40(7): 494-498.
4.	Bidwal M, Lor K, Yu J, et al. Evaluation of asthma medication adherence rates and strategies to improve adherence in the underserved population at a federally qualified health center. Res Social Adm Pharm, 2017, 13(4): 759-766.
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6.	周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心对关于不同类型研究的质量评价工具—患病率及分析性横断面研究的质量评价. 护士进修杂志, 2018, 33(3): 219-221.
7.	张冉, 田庆秀, 余丽君. 支气管哮喘患者吸入糖皮质激素治疗依从性的研究. 中华护理杂志, 2015, 50(1): 42-47.
8.	刘清华, 陶静, 胡慧颖, 等. 哮喘患者感知控制力对糖皮质激素吸入治疗依从性的影响. 护理学杂志, 2017, 32(5): 27-31.
9.	廖丽丽. 成人支气管哮喘患者吸入糖皮质激素治疗依从状况及影响因素. 中国医学创新, 2016, 13(12): 52-54.
10.	潘巍巍, 李非, 阚丽丽, 等. 成人支气管哮喘患者吸入糖皮质激素治疗的依从状况及其影响因素. 临床肺科杂志, 2016, 21(8): 1420-1423.
11.	卢红, 张瑾. 支气管哮喘患者吸入糖皮质激素治疗依从性的研究. 中国社区医师, 2016, 32(13): 152-153.
12.	潘文萍. 支气管哮喘患者吸入糖皮质激素治疗依从性的临床分析. 饮食保健, 2019, 6(47): 37-38.
13.	张小红. 支气管哮喘患者吸入糖皮质激素药物依从性及控制情况的研究. 银川: 宁夏医科大学, 2020.
14.	施宇衡, 汤葳, 段玉香, 等. 上海地区成人哮喘患者治疗依从性的影响因素分析. 国际呼吸杂志, 2019, 39(7): 481-486.
15.	陈海莉, 钟晗, 崔敏, 等. 门诊患者使用吸入制剂依从性调查. 医药导报, 2019, 38(12): 1661-1664.
16.	董正惠. 哮喘患者吸入糖皮质激素治疗依从性和控制率影响因素的研究. 乌鲁木齐: 新疆医科大学, 2008.
17.	王萌. 支气管哮喘患者吸入糖皮质激素治疗依从性的研究. 医药前沿, 2018, 8(21): 107-108.
18.	刘建东, 孙晓光. 支气管哮喘沙美特罗氟替卡松吸入依从性影响因素分析. 中国药业, 2016, 25(1): 92-94.
19.	何登艳, 秦燕. 糖皮质激素吸入治疗支气管哮喘的依从性影响因素及对策. 医疗装备, 2015(12): 12-13.
20.	刘伟. 影响支气管哮喘激素吸入治疗依从性相关因素分析. 医学综述, 2013, 19(7): 1309-1310.
21.	倪孝慈. 影响支气管哮喘患者沙美特罗替卡松粉吸入剂治疗依从性相关因素分析. 中国处方药, 2019, 17(11): 57-58.
22.	黄可可, 颜志婷, 叶海艳, 等. 哮喘患者用药依从性的影响因素分析及干预措施探讨. 中国现代医生, 2019, 57(35): 97-99, 113.
23.	Plaza V, Giner J, Curto E, et al. Assessing adherence by combining the test of adherence to inhalers with pharmacy refill records. J Investig Allergol Clin Immunol, 2021, 31(1): 58-64.
24.	Singh S, Surani S, McGuinness S, et al. Current practice patterns, challenges, and educational needs of asthma care providers in the United States. J Asthma, 2021, 58(8): 1118-1127.
25.	Molimard M, Le Gros V, Robinson P, et al. Prevalence and associated factors of oropharyngeal side effects in users of inhaled corticosteroids in a real-life setting. J Aerosol Med Pulm Drug Deliv, 2010, 23(2): 91-95.
26.	Ban GY, Trinh TH, Ye YM, et al. Predictors of asthma control in elderly patients. Curr Opin Allergy Clin Immunol, 2016, 16(3): 237-243.
27.	Song WJ, Kang MG, Chang YS, et al. Epidemiology of adult asthma in Asia: toward a better understanding. Asia Pac Allergy, 2014, 4(2): 75-85.
28.	Gonzalez-Garcia M, Caballero A, Jaramillo C, et al. Prevalence, risk factors and underdiagnosis of asthma and wheezing in adults 40 years and older: a population-based study. J Asthma, 2015, 52(8): 823-830.
29.	McQuaid EL. Barriers to medication adherence in asthma: the importance of culture and context. Ann Allergy Asthma Immunol, 2018, 121(1): 37-42.
30.	Price D, David-Wang A, Cho SH, et al. Asthma in Asia: physician perspectives on control, inhaler use and patient communications. J Asthma, 2016, 53(7): 761-769.
31.	Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care, 2009, 47(8): 826-834.

1. Huang K, Yang T, Xu J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet, 2019, 394(10196): 407-418.
2. 中华医学会呼吸病学分会哮喘学组. 支气管哮喘患者自我管理中国专家共识. 中华结核和呼吸杂志, 2018, 41(3): 171-178.
3. 林江涛, 王文巧, 周新, 等. 我国 30 个省市城区门诊支气管哮喘患者控制水平的调查结果. 中华结核和呼吸杂志, 2017, 40(7): 494-498.
4. Bidwal M, Lor K, Yu J, et al. Evaluation of asthma medication adherence rates and strategies to improve adherence in the underserved population at a federally qualified health center. Res Social Adm Pharm, 2017, 13(4): 759-766.
5. 尤黎明, 吴瑛. 内科护理学. 6 版. 北京:人民卫生出版社, 2017: 61.
6. 周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心对关于不同类型研究的质量评价工具—患病率及分析性横断面研究的质量评价. 护士进修杂志, 2018, 33(3): 219-221.
7. 张冉, 田庆秀, 余丽君. 支气管哮喘患者吸入糖皮质激素治疗依从性的研究. 中华护理杂志, 2015, 50(1): 42-47.
8. 刘清华, 陶静, 胡慧颖, 等. 哮喘患者感知控制力对糖皮质激素吸入治疗依从性的影响. 护理学杂志, 2017, 32(5): 27-31.
9. 廖丽丽. 成人支气管哮喘患者吸入糖皮质激素治疗依从状况及影响因素. 中国医学创新, 2016, 13(12): 52-54.
10. 潘巍巍, 李非, 阚丽丽, 等. 成人支气管哮喘患者吸入糖皮质激素治疗的依从状况及其影响因素. 临床肺科杂志, 2016, 21(8): 1420-1423.
11. 卢红, 张瑾. 支气管哮喘患者吸入糖皮质激素治疗依从性的研究. 中国社区医师, 2016, 32(13): 152-153.
12. 潘文萍. 支气管哮喘患者吸入糖皮质激素治疗依从性的临床分析. 饮食保健, 2019, 6(47): 37-38.
13. 张小红. 支气管哮喘患者吸入糖皮质激素药物依从性及控制情况的研究. 银川: 宁夏医科大学, 2020.
14. 施宇衡, 汤葳, 段玉香, 等. 上海地区成人哮喘患者治疗依从性的影响因素分析. 国际呼吸杂志, 2019, 39(7): 481-486.
15. 陈海莉, 钟晗, 崔敏, 等. 门诊患者使用吸入制剂依从性调查. 医药导报, 2019, 38(12): 1661-1664.
16. 董正惠. 哮喘患者吸入糖皮质激素治疗依从性和控制率影响因素的研究. 乌鲁木齐: 新疆医科大学, 2008.
17. 王萌. 支气管哮喘患者吸入糖皮质激素治疗依从性的研究. 医药前沿, 2018, 8(21): 107-108.
18. 刘建东, 孙晓光. 支气管哮喘沙美特罗氟替卡松吸入依从性影响因素分析. 中国药业, 2016, 25(1): 92-94.
19. 何登艳, 秦燕. 糖皮质激素吸入治疗支气管哮喘的依从性影响因素及对策. 医疗装备, 2015(12): 12-13.
20. 刘伟. 影响支气管哮喘激素吸入治疗依从性相关因素分析. 医学综述, 2013, 19(7): 1309-1310.
21. 倪孝慈. 影响支气管哮喘患者沙美特罗替卡松粉吸入剂治疗依从性相关因素分析. 中国处方药, 2019, 17(11): 57-58.
22. 黄可可, 颜志婷, 叶海艳, 等. 哮喘患者用药依从性的影响因素分析及干预措施探讨. 中国现代医生, 2019, 57(35): 97-99, 113.
23. Plaza V, Giner J, Curto E, et al. Assessing adherence by combining the test of adherence to inhalers with pharmacy refill records. J Investig Allergol Clin Immunol, 2021, 31(1): 58-64.
24. Singh S, Surani S, McGuinness S, et al. Current practice patterns, challenges, and educational needs of asthma care providers in the United States. J Asthma, 2021, 58(8): 1118-1127.
25. Molimard M, Le Gros V, Robinson P, et al. Prevalence and associated factors of oropharyngeal side effects in users of inhaled corticosteroids in a real-life setting. J Aerosol Med Pulm Drug Deliv, 2010, 23(2): 91-95.
26. Ban GY, Trinh TH, Ye YM, et al. Predictors of asthma control in elderly patients. Curr Opin Allergy Clin Immunol, 2016, 16(3): 237-243.
27. Song WJ, Kang MG, Chang YS, et al. Epidemiology of adult asthma in Asia: toward a better understanding. Asia Pac Allergy, 2014, 4(2): 75-85.
28. Gonzalez-Garcia M, Caballero A, Jaramillo C, et al. Prevalence, risk factors and underdiagnosis of asthma and wheezing in adults 40 years and older: a population-based study. J Asthma, 2015, 52(8): 823-830.
29. McQuaid EL. Barriers to medication adherence in asthma: the importance of culture and context. Ann Allergy Asthma Immunol, 2018, 121(1): 37-42.
30. Price D, David-Wang A, Cho SH, et al. Asthma in Asia: physician perspectives on control, inhaler use and patient communications. J Asthma, 2016, 53(7): 761-769.
31. Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care, 2009, 47(8): 826-834.

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