TY-JUR T1 - 粘附到吸入的皮质类固醇随着时间的推移预测哮喘相关的结果吗？队列研究JF - 欧洲呼吸期刊Jo - Eur Respir J Do - 10.1183 / 13993003.00901-2019 VL - 54是 - 6 SP - 1900901 Au - Dima，Alexandra L. Au - Van Ganse，Eric Au - Stadler，Gertraud Au - DeBruin，Marijn A2 - ，Y1 - 2019/12/01 Ur - //www.qdcxjkg.com/content/54/6/1900901.abstract n2 - 吸入的皮质类固醇（ICS）遵守对于哮喘管理很重要。目前关于ICS遵守对结果的影响的现有证据主要是基于人与人之间的数据分析。虽然众所周知，哮喘结果随着时间的推移而波动，但人内变化的预测因子的证据是稀缺的。我们旨在量化这些波动和人类水平之间的ICS依从性和结果之间的纵向关系。法国和英国持续哮喘患者的前瞻性队列（N = 847岁，6-40岁）提供3756通过计算机辅助电话访谈和ICS粘附，哮喘控制，救济药物用途和恶化的短信报告最多2年。我们通过纵向模型检查了依从性关系，控制混淆，包括严重程度。发现局部可变异性，用于加剧（91％），哮喘控制（59％）和救济使用（52％）;431（11.5％）报告标志性的加剧和2046（54.5％）控制不良。在人类水平之间，平均依从性更高的患者更有可能报告哮喘控制（或1.25,95％CI 1.06-1.47），但不是哮喘加剧（或0.99,95％CI 0.87-1.12）或更低的缓解使用（B -0.0004,95％CI -0.089-0.088）。 At within-person level, higher-than-usual adherence was associated with higher concomitant reliever use (b 0.092, 95% CI 0.053−0.131) and lower subsequent reliever use (b −0.047, 95% CI −0.005− −0.088); it was unrelated to asthma control (OR 0.93, 95% CI 0.84−1.02) or exacerbations (OR 1.04, 95% CI 0.94−1.16).Patients maintaining high ICS adherence over time have better asthma control. Temporarily increasing ICS adherence tends to be simultaneous to higher reliever use and reduces reliever use later on. Causes of within-person variation in outcomes require more investigation.Cohort study in routine care finds large variability in asthma outcomes over time. Patients with higher mean ICS adherence report better asthma control. ICS adherence and reliever use tend to increase at the same time and reduce use of relievers later on. http://bit.ly/2kK1bbv ER -