Araştırma Makalesi
BibTex RIS Kaynak Göster

ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ

Yıl 2020, Cilt: 21 Sayı: 4, 319 - 326, 14.10.2020
https://doi.org/10.18229/kocatepetip.573382

Öz

AMAÇ: Astım çocukluk çağının en sık kronik hastalıklarından biridir. Çalışmamızın amacı polikliniğimizde astım tanısı ile iz-lenen hastalarımızın demografik, klinik, laboratuvar özelliklerini incelemek, verilen tedavileri, hastaların ilaç kullanım tekniği doğruluğu ve ilaç uyumunu değerlendirmektir. GEREÇ VE YÖNTEM: Polikliniğimizde astım tanısı alan 188 hastanın dosyalarından yaş, cinsiyet, ailesel atopi, pasif sigara maruziyeti verileri kaydedildi. Kan mutlak eozinofil sayısı, serum total IgE, alerjen spesifik IgE, cilt delme testi, besin yükleme testi sonuçları incelendi. Hastalar Global Initiative for Asthma (GINA 2018) ve Allergic Rhinitis and its Impact on Asthma (ARIA 2016) kılavuzlarına göre hastalık kontrol/ağırlık gruplarına ayrıldı. Astım kontrol testi, çocukluk çağı astım kontrol testi ve çocuklar için solunum ve astım kontrol testi sonuçları kaydedildi. Hastaların başvuruda almakta olduğu ve tarafımızca başlanan tedaviler incelendi. Başvuru ve ilk kontrol muayenelerinde inhaler tekniklerin doğru uygulanması ve ilaç uyumu değerlendirildi. Bu değerlendirmeler için tanımlayıcı istatistiksel analizler kullanıldı. BULGULAR: Hastaların yaş ortalaması 8,41±3,52 yaş (1,5-16,5) ve 107 (%56,9) hasta erkek idi. 52 hastada ailesel atopi, 60 has-tada sigara maruziyeti vardı. Hastalar astım açısından en çok iyi kontrollü, alerjik rinit açısından en çok orta-ağır grupların-daydı. 82 hastada solunumsal alerjen duyarlılığı, iki hastada da besin alerjisi saptanmıştı. Hastaların %39,89’una dış merkezde, %31,91’ine tarafımızca kontrol edici tedavi başlanmıştı. İlaç uyu-mu bilgisine ulaşılabilen hastaların %33,59’unun ilaç uyumsuz hasta olduğu görüldü. Hastaların %39,28’inin başvuruda, en az bir kez kontrole gelenlerin %24,48’inin kontrol muayenesinde inhaler tekniği doğru uygulamadığı görüldü.SONUÇ: Çalışmamızda ilimizdeki astımlı çocuk hastaların demografik, klinik, laboratuvar bulguları, tedavileri ve tedavi uyumları değerlendirilmiştir. Ailede astım varlığı ve alerjik rinit eşlik etme sıklıkları literatürle uyumludur. Tedavide ağırlık/kont-rol düzeyinin dikkate alınması tekrar hatırlanmalıdır. İlaç uyumsuzluğu ve yanlış teknikle kullanım hastalarımızda da yüksek oranda olup tedavi başarısı için akılda tutulmalıdır. Ülkemizdeki astımlı çocukların değerlendirildiği literatürdeki az sayıdaki çalışmaya katkıda bulunulmuştur.

Kaynakça

  • 1. Türk Toraks Derneği Astım Allerji Çalışma Grubu Yürütme Kurulu. Türk Toraks Derneği Astım Tanı ve Tedavi Rehberi. Ankara: Bilimsel Tıp Yayınevi; 2016.
  • 2. Global Initiative for Asthma. Global Strategy for Asthma Management and prevention, 2018. Available from: www.ginasthma.org
  • 3. Bjerg A, Hedman L, Perzanowski MS, Platts-Mills T, Lundbäck B, Rönmark E. Family history of asthma and atopy: in-depth analyses of the impact on asthma and wheeze in 7- to 8-year-old children. Pediatrics 2007; 120: 741-8.
  • 4. Subbarao P, Mandhane PJ, Sears MR. Asthma: epidemiology, etiology and risk factors. CMAJ 2009; 181: E181-90.
  • 5. Tesse R, Borrelli G, Mongelli G, Mastrorilli V, Cardinale F. Treating Pediatric Asthma According Guidelines. Front Pediatr 2018; 23; 234.
  • 6. National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK7232/
  • 7. Uysal MA, Mungan D, Yorgancioglu A, et al. The validation of the Turkish version of Asthma Control Test. Qual Life Res 2013; 22: 1773-9.
  • 8. Sekerel BE, Soyer OU, Keskin O, et al. The reliability and validity of Turkish version of ChildhoodAsthma Control Test. Qual Life Res 2012; 21: 685-90.
  • 9. Buyuktiryaki B, Sahiner UM, Yavuz ST, et al. Validation of the Turkish version of "Test for Respiratory and Asthma Control in Kids (TRACK)" questionnaire. J Asthma 2013; 50: 1096-101.
  • 10. Desager K, Vermeulen F, Bodart E. Adherence to asthma treatment in childhood and adolescence – a narrative literature review. Acta Clinica Belgica 2018; 73: 348-55.
  • 11. Giavina-Bianchi P, Aun MV, Takejima P, Kalil J, Agondi RC. United airway disease: current perspectives. J Asthma Allergy 2016; 9: 93-100.
  • 12. Hatoun J, Davis-Plourde K, Penti B, Cabral H, Kazis L. Tobacco Control Laws and Pediatric Asthma. Pediatrics 2018;141(Suppl 1): 130-6.
  • 13. Brożek JL, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 2017; 140: 950-8.
  • 14. Kim HY, Shin YH, Han MY. Determinants of sensitization to allergen in infants and young children. Korean J Pediatr 2014; 57: 205-10.
  • 15. Gibbs K, Collaco JM, McGrath-Morrow SA. Impact of Tobacco Smoke and Nicotine Exposure on Lung Development. Chest 2016; 149: 552-61.
  • 16. Maritz GS. Perinatal exposure to nicotine and implications for subsequent obstructive lung disease. Paediatr Respir Rev 2013; 14: 3-8.
  • 17. Gonzalez-Barcala FJ, Pertega S, Sampedro M, et al. Impact of parental smoking on childhood asthma. J Pediatr (Rio J) 2013; 89: 294-9.
  • 18. Kobayashi Y, Bossley C , Gupta A, et al. Passive Smoking Impairs Histone Deacetylase-2 in Children With Severe Asthma. Chest 2014; 145: 305–12.
  • 19. Bloomberg GR, Banister C, Sterkel R, et al. Socioeconomic, Family, and Pediatric Practice Factors Affecting the Level of Asthma Control. Pediatrics 2009; 123: 829–35.
  • 20. Craig TJ. Aeroallergen sensitization in asthma: prevalence and correlation with severity. Allergy Asthma Proc 2010; 31: 96-102.
  • 21. Farrokhi S, Gheybi MK, Movahed A, et al. Common aeroallergens in patients with asthma and allergic rhinitis living in southwestern part of Iran: based on skin prick test reactivity. Iran J Allergy Asthma Immunol 2015; 14: 133-8.
  • 22. Ozkaya E, Sogut A, Küçükkoç M, et al. Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey. Int J Biometeorol 2015; 59: 1685-90.
  • 23. Kewalramani A, Bollinger ME. The impact of food allergy on asthma. Journal of Asthma and Allergy 2010; 28: 65–74.
  • 24. James JM, Bernhisel-Broadbent J, Sampson HA. Respiratory reactions provoked by double-blind food challenges in children. Am J Respir Crit Care Med 1994; 149: 59–64.
  • 25. Hossny E, Rosario N, Lee BW, et al. The use of inhaled corticosteroids in pediatric asthma: update. World Allergy Organ J 2016; 9: 26.
  • 26. Hinchageri S, Neelkanthreddy P, Khavane K, Bhanda SH, Swarnakamala K. Assessment of medication adherence and factors affecting to mediaction adherence in asthma patients by clinical pharmacist. Inter Res J Pharma 2012; 3: 211-5.
  • 27. Jabeen U, Zeeshan F, Bano I, Bari A, Rathore AW. Adherence to asthma treatment and their association with asthma control in children. J Pak Med Assoc 2018; 68: 725-8.
  • 28. Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005; 50: 1360-74.

EVALUATION OF DEMOGRAPHIC, CLINICAL AND LABORATORY CHARACTERISTICS OF PEDIATRIC PATIENTS WITH ASTHMA

Yıl 2020, Cilt: 21 Sayı: 4, 319 - 326, 14.10.2020
https://doi.org/10.18229/kocatepetip.573382

Öz

OBJECTIVE: Asthma is one of the most prevalent chronic diseases of childhood. The aim of the study was to evaluate the demographic, clinical and laboratory characteristics of our patients who are followed up with diagnosis of asthma in our clinic, and to evaluate the treatments given, the correctness of the patients' drug use technique and drug compliance.
MATERIAL AND METHODS: Data of age, sex, familial atopy, passive smoking exposure of 188 asthma patients were recorded from their patient files. Absolute eosinophil count, serum total IgE and allergen-specific IgE levels, skin prick test and oral food provocation test results at presentation were investigated. The patients were grouped according to disease control/severity based on the Global Initiative for Asthma (GINA 2018) and Allergic Rhinitis and its Impact on Asthma (ARIA 2016) guidelines. The patients’ asthma control test, childhood asthma control test and test for respiratory and asthma control in kids’ scores were recorded. The previously prescribed treatment at presentation or newly started treatments were investigated. The patients were evaluated for their correct inhaler utilization techniques at presentation and the first follow-up visit. Descriptive statistics were used for these evaluations.
RESULTS: The mean age of the patients was 8,41±3,52 (1,5-16,5) years, and 107 (56,9%) of them were boys. Familial atopy was present in 52, and smoking exposure in 60 patients. Most of the patients were well-controlled for asthma, and moderate-to-severe severity for allergic rhinitis. 82 of the patients had aeroallergen sensitivity, and two were diagnosed with food allergy. The controller medication was started by an external healthcare center in 39,89% of the patients and by us in 31,91% of the patients. Results demonstrated that 33,59% of the patients whose medication adherence information could be obtained were non-adherent. It was observed that 39,28% of the patients and 24,48% of the patients who came for control at least once did not utilize a correct inhaler technique during the control examination.
CONCLUSIONS: In the current study, the demographic, clinical and laboratory results, prescribed treatments and treatment adherence of the pediatric patients with asthma residing in our city were evaluated. Presence of asthma in the family and frequency of accompanying allergic rhinitis are consistent with the literature. It should be remembered to consider the weight/control level in the treatment. Drug incompatibility and using it with wrong technique is also high in our patients and this situation should be kept in mind for the success of the treatment. These results will contribute to the few studies in the literature evaluating children with asthma.

Kaynakça

  • 1. Türk Toraks Derneği Astım Allerji Çalışma Grubu Yürütme Kurulu. Türk Toraks Derneği Astım Tanı ve Tedavi Rehberi. Ankara: Bilimsel Tıp Yayınevi; 2016.
  • 2. Global Initiative for Asthma. Global Strategy for Asthma Management and prevention, 2018. Available from: www.ginasthma.org
  • 3. Bjerg A, Hedman L, Perzanowski MS, Platts-Mills T, Lundbäck B, Rönmark E. Family history of asthma and atopy: in-depth analyses of the impact on asthma and wheeze in 7- to 8-year-old children. Pediatrics 2007; 120: 741-8.
  • 4. Subbarao P, Mandhane PJ, Sears MR. Asthma: epidemiology, etiology and risk factors. CMAJ 2009; 181: E181-90.
  • 5. Tesse R, Borrelli G, Mongelli G, Mastrorilli V, Cardinale F. Treating Pediatric Asthma According Guidelines. Front Pediatr 2018; 23; 234.
  • 6. National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK7232/
  • 7. Uysal MA, Mungan D, Yorgancioglu A, et al. The validation of the Turkish version of Asthma Control Test. Qual Life Res 2013; 22: 1773-9.
  • 8. Sekerel BE, Soyer OU, Keskin O, et al. The reliability and validity of Turkish version of ChildhoodAsthma Control Test. Qual Life Res 2012; 21: 685-90.
  • 9. Buyuktiryaki B, Sahiner UM, Yavuz ST, et al. Validation of the Turkish version of "Test for Respiratory and Asthma Control in Kids (TRACK)" questionnaire. J Asthma 2013; 50: 1096-101.
  • 10. Desager K, Vermeulen F, Bodart E. Adherence to asthma treatment in childhood and adolescence – a narrative literature review. Acta Clinica Belgica 2018; 73: 348-55.
  • 11. Giavina-Bianchi P, Aun MV, Takejima P, Kalil J, Agondi RC. United airway disease: current perspectives. J Asthma Allergy 2016; 9: 93-100.
  • 12. Hatoun J, Davis-Plourde K, Penti B, Cabral H, Kazis L. Tobacco Control Laws and Pediatric Asthma. Pediatrics 2018;141(Suppl 1): 130-6.
  • 13. Brożek JL, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 2017; 140: 950-8.
  • 14. Kim HY, Shin YH, Han MY. Determinants of sensitization to allergen in infants and young children. Korean J Pediatr 2014; 57: 205-10.
  • 15. Gibbs K, Collaco JM, McGrath-Morrow SA. Impact of Tobacco Smoke and Nicotine Exposure on Lung Development. Chest 2016; 149: 552-61.
  • 16. Maritz GS. Perinatal exposure to nicotine and implications for subsequent obstructive lung disease. Paediatr Respir Rev 2013; 14: 3-8.
  • 17. Gonzalez-Barcala FJ, Pertega S, Sampedro M, et al. Impact of parental smoking on childhood asthma. J Pediatr (Rio J) 2013; 89: 294-9.
  • 18. Kobayashi Y, Bossley C , Gupta A, et al. Passive Smoking Impairs Histone Deacetylase-2 in Children With Severe Asthma. Chest 2014; 145: 305–12.
  • 19. Bloomberg GR, Banister C, Sterkel R, et al. Socioeconomic, Family, and Pediatric Practice Factors Affecting the Level of Asthma Control. Pediatrics 2009; 123: 829–35.
  • 20. Craig TJ. Aeroallergen sensitization in asthma: prevalence and correlation with severity. Allergy Asthma Proc 2010; 31: 96-102.
  • 21. Farrokhi S, Gheybi MK, Movahed A, et al. Common aeroallergens in patients with asthma and allergic rhinitis living in southwestern part of Iran: based on skin prick test reactivity. Iran J Allergy Asthma Immunol 2015; 14: 133-8.
  • 22. Ozkaya E, Sogut A, Küçükkoç M, et al. Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey. Int J Biometeorol 2015; 59: 1685-90.
  • 23. Kewalramani A, Bollinger ME. The impact of food allergy on asthma. Journal of Asthma and Allergy 2010; 28: 65–74.
  • 24. James JM, Bernhisel-Broadbent J, Sampson HA. Respiratory reactions provoked by double-blind food challenges in children. Am J Respir Crit Care Med 1994; 149: 59–64.
  • 25. Hossny E, Rosario N, Lee BW, et al. The use of inhaled corticosteroids in pediatric asthma: update. World Allergy Organ J 2016; 9: 26.
  • 26. Hinchageri S, Neelkanthreddy P, Khavane K, Bhanda SH, Swarnakamala K. Assessment of medication adherence and factors affecting to mediaction adherence in asthma patients by clinical pharmacist. Inter Res J Pharma 2012; 3: 211-5.
  • 27. Jabeen U, Zeeshan F, Bano I, Bari A, Rathore AW. Adherence to asthma treatment and their association with asthma control in children. J Pak Med Assoc 2018; 68: 725-8.
  • 28. Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005; 50: 1360-74.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Sehra Birgül Batmaz 0000-0003-1913-5346

Yayımlanma Tarihi 14 Ekim 2020
Kabul Tarihi 27 Ocak 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 21 Sayı: 4

Kaynak Göster

APA Batmaz, S. B. (2020). ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ. Kocatepe Tıp Dergisi, 21(4), 319-326. https://doi.org/10.18229/kocatepetip.573382
AMA Batmaz SB. ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ. KTD. Ekim 2020;21(4):319-326. doi:10.18229/kocatepetip.573382
Chicago Batmaz, Sehra Birgül. “ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ”. Kocatepe Tıp Dergisi 21, sy. 4 (Ekim 2020): 319-26. https://doi.org/10.18229/kocatepetip.573382.
EndNote Batmaz SB (01 Ekim 2020) ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ. Kocatepe Tıp Dergisi 21 4 319–326.
IEEE S. B. Batmaz, “ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ”, KTD, c. 21, sy. 4, ss. 319–326, 2020, doi: 10.18229/kocatepetip.573382.
ISNAD Batmaz, Sehra Birgül. “ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ”. Kocatepe Tıp Dergisi 21/4 (Ekim 2020), 319-326. https://doi.org/10.18229/kocatepetip.573382.
JAMA Batmaz SB. ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ. KTD. 2020;21:319–326.
MLA Batmaz, Sehra Birgül. “ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ”. Kocatepe Tıp Dergisi, c. 21, sy. 4, 2020, ss. 319-26, doi:10.18229/kocatepetip.573382.
Vancouver Batmaz SB. ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ. KTD. 2020;21(4):319-26.

88x31.png
Bu Dergi Creative Commons Atıf-GayriTicari-AynıLisanslaPaylaş 4.0 Uluslararası Lisansı ile lisanslanmıştır.