RESUMO
BACKGROUND: The provision of written asthma action plans (WAAPs) is regarded by regional and international guidelines as an essential component of patient education and self-management. However, the evidence for this practice in children is deficient. AIM: To evaluate the effectiveness of adding a personalized WAAP in the treatment of children with partly controlled asthma. METHODS: Children with partly controlled asthma were randomized to receive a personalized WAAP or no plan, in addition to standard care including education. They were followed up with serial measurement of outcome variables. The primary outcome measured was the number of emergency room (ER) revisits. RESULTS: Ninety-one children participated, 45 in the intervention group and 46 in the control group. Comparison with pretrial data revealed significantly improved outcomes with respect to the numbers of ER visits ( p = 0.005 and 0.0002) and acute asthmatic attacks ( p = 0.0064 and 0.0006) in both arms of the study. Children in receipt of a personalized WAAP had fewer ER visits ( p = 0.78), asthma attacks ( p = 0.84), missed school days ( p = 0.28), night-time awakenings ( p = 0.48) and unscheduled doctor visits ( p = 0.69) than those who did not receive a plan. CONCLUSION: The results of this study suggest that the provision of personalized WAAPs may play a useful role in the management of children with partly controlled asthma but is no better than standard care. Asthma education is a critical component in the prevention of exacerbations in children with partly controlled asthma.
Assuntos
Asma/terapia , Gerenciamento Clínico , Serviço Hospitalar de Emergência/estatística & dados numéricos , Planejamento de Assistência ao Paciente , Autocuidado/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Avaliação de Resultados em Cuidados de Saúde , Cooperação do Paciente , Guias de Prática Clínica como Assunto , Avaliação de Programas e Projetos de Saúde , Estatísticas não Paramétricas , Trinidad e TobagoRESUMO
OBJECTIVES: To explore the association between gender and (1) attendance and (2) compliance with treatment in a population of patients with diabetes who attended outpatient clinics in the island of Trinidad (Trinidad and Tobago). METHODS: A cross-sectional study was conducted with a sample of 360 patients who met the selection criteria. Simple consecutive sampling and a questionnaire were used to interview clinic attendees at two urban clinics in east and south Trinidad. RESULTS: 74.2% (267) of the participants were women. A higher percentage of women than men were unemployed (79.4% vs. 59.1%, P < 0.001). Men were more likely to consume alcohol (26.9% vs. 11.6%, P < 0.001) and smoke cigarettes (20.4% vs. 5.6%, P < 0.001). Women were more compliant than men regarding diet (39.3% vs. 22.6%, P < 0.005) and prescribed medication (71.9% vs. 65.6%, P < 0.04). Women were more satisfied than men with dispensary (81.3% vs. 71.0%, P < 0.04) and clinic conditions (92.1% vs. 84.9%, P < 0.05). CONCLUSIONS: More women attended the clinic, and their compliance with the treatment regimen was better than in men. The latter were more likely to engage in health risk behaviors such as drinking and smoking. Efforts focused on men with diabetes mellitus in Trinidad and Tobago are needed to encourage greater compliance.
Assuntos
Diabetes Mellitus Tipo 2/terapia , Cooperação do Paciente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Instituições de Assistência Ambulatorial , Estudos Transversais , Interpretação Estatística de Dados , Educação , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Fatores Sexuais , Fumar , Trinidad e TobagoRESUMO
Objectives. To explore the association between gender and (1) attendance and (2) compliance with treatment in a population of patients with diabetes who attended outpatient clinics in the island of Trinidad (Trinidad and Tobago). Methods. A cross-sectional study was conducted with a sample of 360 patients who met the selection criteria. Simple consecutive sampling and a questionnaire were used to interview clinic attendees at two urban clinics in east and south Trinidad. Results. 74.2% (267) of the participants were women. A higher percentage of women than men were unemployed (79.4% vs. 59.1%, P < 0.001). Men were more likely to consume alcohol (26.9% vs. 11.6%, P < 0.001) and smoke cigarettes (20.4% vs. 5.6% , P < 0.001). Women were more compliant than men regarding diet (39.3% vs. 22.6%, P < 0.005) and prescribed medication (71.9% vs. 65.6%, P < 0.04). Women were more satisfied than men with dispensary (81.3% vs. 71.0%, P < 0.04) and clinic conditions (92.1% vs. 84.9%, P < 0.05). Conclusions. More women attended the clinic, and their compliance with the treatment regimen was better than in men. The latter were more likely to engage in health risk behaviors such as drinking and smoking. Efforts focused on men with diabetes mellitus in Trinidad and Tobago are needed to encourage greater compliance.
OBJETIVOS: Explorar la asociación entre el género y 1) la asistencia a consultas y 2) el cumplimiento del tratamiento en una población de pacientes con diabetes sacarina (mellitus) atendida en clínicas ambulatorias de la isla de Trinidad (en Trinidad y Tabago). MÉTODOS: Se llevó a cabo un estudio transversal con una muestra de 360 pacientes que llenaron los requisitos de inclusión. Se realizó un muestreo sencillo de pacientes consecutivos y se aplicó un cuestionario para entrevistar a personas atendidas en dos clínicas ambulatorias urbanas del oriente y sur de Trinidad. RESULTADOS: De los participantes, 74,2% eran mujeres. En términos porcentuales, más mujeres que hombres estaban sin empleo (79,4% frente a 59,1%; P < 0,001). Los hombres mostraron una mayor tendencia que las mujeres a consumir alcohol (26,9% frente a 11,6%; P < 0,001) y a fumar cigarrillos (20,4% frente a 5,6%; P < 0,001). Las mu-jeres observaron más el régimen alimentario que los hombres (39,3% frente a 22,6%; P < 0,005) y se ciñeron más que estos a los medicamentos prescritos (71,9% frente a 65,6%; P < 0,04). Las mujeres se mostraron más satisfechas que los hombres con las condiciones imperantes en los dispensarios (81,3% frente a 71,0%; P < 0,04) y clínicas (92,1% frente a 84,9%; P < 0,05). CONCLUSIONES: Más mujeres que hombres asistían a la clínica y el acatamiento del régimen terapéutico fue mayor entre las mujeres que entre los hombres. Estos se mostraron más propensos que las mujeres a incurrir en conductas peligrosas para la salud, tales como beber y fumar. Se necesitan intervenciones dirigidas hacia los hombres con diabetes sacarina en Trinidad y Tabago a fin de fomentar un mayor cumplimiento del tratamiento prescrito.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , /terapia , Cooperação do Paciente , Consumo de Bebidas Alcoólicas , Instituições de Assistência Ambulatorial , Estudos Transversais , Interpretação Estatística de Dados , Educação , Emprego , Satisfação do Paciente , Fatores Sexuais , Fumar , Trinidad e TobagoRESUMO
OBJECTIVES. To explore the association between gender and (1) attendance and (2) compliance with treatment in a population of patients with diabetes who attended outpatient clinics in the island of Trinidad (Trinidad and Tobago). METHODS. A cross-sectional study was conducted with a sample of 360 patients who met the selection criteria. Simple consecutive sampling and a questionnaire were used to interview clinic attendees at two urban clinics in east and south Trinidad. RESULTS. 74.2 percent (267) of the participants were women. A higher percentage of women than men were unemployed (79.4 percent vs. 59.1 percent, P less than 0.001). Men were more likely to consume alcohol(26.9 percent vs. 11.6 percent, P less than 0.001) and smoke cigarettes (20.4 percent vs. 5.6 percent , P less than 0.001). Women were more compliant than men regarding diet (39.3 percent vs. 22.6 percent, P percent 0.005) and prescribed medication (71.9 percent vs. 65.6 percent, P less than 0.04). Women were more satisfied than men with dispensary (81.3 percent vs. 71.0 percent, P less than 0.04) and clinic conditions (92.1 percent vs. 84.9 percent, P less than 0.05). CONCLUSIONS. More women attended the clinic, and their compliance with the treatment regimen was better than in men. The latter were more likely to engage in health risk behaviors such as drinking and smoking. Efforts focused on men with diabetes mellitus in Trinidad and Tobago are needed to encourage greater compliance.