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Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities

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World Journal of Pediatrics 2018年第5期14卷 482-491页

作者： Kam Lun Hon Yan Min Bao Kate C.Chan Kin Wai Chau Rong-Shan Chen Kun Tat Gary Cheok Wa Keung Chiu Li Deng Chun-Hui He Kin Mui Ieong Jeng Sum C.Kung Ping Lam Shu Yan David Lam Qun Ui Lee So Lun Lee Ting Fan Leung Theresa N.H.Leung Lei Shi Ka Ka Siu Wei-Ping Tan Maggie Haitian Wang Tak Wai Wong Bao-Jing Wu Ada Y.F.yip Yue-Jie Zheng Daniel K.Ng Department of Pediatrics The Chinese University of Hong Kong 6/F Prince of Wales HospitalRoom 84042ShatinN.THong Kong SARChina Department ofR espiratory Diseases Shenzhen Children’s HospitalShenzhen 518026China Hong Kong Society of P ediatric Respirology and Aller gy Hong K ong S ARChina Pediatric Respiratory andSleep Disorders Center Room 1315DArgyle Centre Phase 1688 Nathan RoadMongkokKowloonHong K ong S ARChina Department of R espiration Guangzhou Women and Children’s Medical CenterGuangzhou 510623China Department of P ediatrics Kiang Wu HospitalMacaoChina Department of P ediatrics and A dolescent Medicine United Christian Hospital130Hip Wo StreetKwun TongHong K ong S ARChina Department of P ediatrics Central Hospital Conde S.JanuarioMacaoChina Department of P ediatrics and A dolescent Medicine Caritas Medical Center111Wing Hong StreetSham Shui PoHong K ong S ARChina Department of P ediatrics and A dolescent Medicine Tuen Mun Hospital23 Tsing Chung Koon RoadTuen MunNewT erritoriesHongK ongS ARChina Department of P ediatrics and A dolescent Medicine Princess Margaret Hospital2-10 Princess Margaret Hospital RoadLai Chi KokKowloonHong K ong S ARChina Department of P ediatrics and A dolescent Medicine Queen Mary Hospital102Pokfulam RoadHong K ong S ARChina Department of P ediatrics and A dolescent Medicine The University of Hong KongHong K ong S ARChina Department of P ediatrics and A dolescent Medicine Pamela Youde Nethersole Eastern Hospital3Lok Man RoadChaiwanHong K ong S ARChina Department of P ediatrics The University of Hong Kong-Shenzhen Hospital1Haiyuan 1st RoadFutianShenzhenChina Department of P ediatrics and A dolescent Medicine Kwong Wah Hospital25 Waterloo RoadKLN Hong K ong S ARChina Department of P ediatrics Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China JC School of Public Health and Primary Care Faculty of MedicineThe Chinese University of Hong KongHong K ong S ARChina Department of P ediatrics and A dolescen

Background Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta. Methods The conjoint survey involved ten Hong Kong pediatric hospitals/units, two Shenzhen hospitals, two Macao hos-pitals, and two Guangzhou hospitals on asthma control (using Asthma Control Test) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ). Acceptability of a treatment is graded as very good/good/fair/poor. Results Good asthma control was only reported in 80% subjects in Hong Kong, but higher in sister cities (85–94%, P<0.001). Allergic rhinitis, 'incense burning', and 'smoker in family' were prevalent among the four cities. Logistic regres-sion showed better control of asthma was associated with better PADQLQ (B=?0.029, P < 0.001), better acceptability of bronchodilator (B=?1.488, P = 0.025), negatively with 'smoker in family' (B=?0.83, P = 0.015) and various PADQLQ domains. Conversely, worse PADQLQ was associated with allergic rhinitis severity (B=4.77, P <0.001), poor control of asthma (B=7.56, P <0.001), increased frequency of traditional Chinese medicine use (B=1.7, P < 0.05), increased fre-quency of bronchodilator usage (B=1.05, P < 0.05), 'smoker in family' (B=4.05, P < 0.05), and incense burning at home (B=3.9, P < 0.05). Conclusions There are some clinical and cultural differences among the four southern Chinese cities within the Guangdong province. This study identifies potentially modifiable environmental and treatment factors associated with poor asthma control and QoL for health-care interventions. Having a smoker in the family is independently associated with poor asthma control and QoL.

关键词： Asthma Complementary and alternative medicine Control Inhaled bronchodilator Inhaled corticosteroid Pediatric Allergic Disease Quality of Life Questionnaire Smoking Traditional Chinese medicine

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