The Relationship Between Compliance And Efficacy In Children ≤5 Years Old With Asthma Was Analyzed Using The Chinese Children’s Asthma Action Plan

Objective:To explore the compliance of asthmatic children in the asthma action plan based on internet platform,and the influence of the difference of compliance on the control of asthma,to evaluate the value of an electronic version of the Chinese Children’s Asthma Action Plan in outpatient treatment for children aged 5 years and younger.Methods:(1)To evaluate the relationship between compliance and treatment outcomes in children with asthma aged 5 years and younger:400 children with asthma were admitted to the asthma clinic of the Affiliated to Qingdao University from August 2017 to December 2019 for the first time and were treated with inhaled corticosteroids(ICS),included in the electronic version of China Children Asthma Action Plan(CCAAP)management(software name:Breath Mint).According to the drug compliance,as prescribed by the doctor,patients were treated with corticosteroids for more than 3 months and were admitted to the experimental group,and those who were treated with corticosteroids for less than 1 month not as prescribed by medical advice were admitted to the control group.A specialist nurse demonstrates the use of the electronic version of CCAAP at the initial visit.The specialist informs the patient about the current“Traffic light”area(asthma control rating),which is a precursor to an acute attack,inform them of the daily monitoring of symptoms,record medication use,and complete monthly Test for Respiratory and Asthma control questionnaires(TRACK),communicate with clinician via electronic CCAAP Mobile Terminal.We compared the number of acute asthma attacks,emergency visits,hospital stays and the score of TRACK questionnaire to assess the control of asthma(Once a month,13 times in total).SPSS 25 was used to carry out statistical analysis,the mean±standard deviation was used to express the measurement data,the case(rate)was used to express the count data,and Mann-whitney U test was used to test the measurement data which did not agree with the normal distribution The counting data were analyzed byχ~2test.P<0.05 the difference was statistically significant.(2)Analysis of influencing factors of compliance:130 questionnaires were randomly distributed among the patients with follow-up visit,and the questionnaires were filled out by parents through mobile phone,the contents of the survey included:(1)general situation:including children’s age and sex,parents’age and sex,place of residence,family income,parents’educational level;(2)the knowledge of asthma and the knowledge of drugs,and divided into experimental group and control group according to the compliance,the sex,parents’sex and age,parents’educational level,residence,monthly family income and knowledge of asthma and medicine were compared between the two groups,and the influencing factors were analyzed.Result:(1)1.Basic information:this study included 400 children with asthma,the age of the children was 5 years and younger.The mean age was(3.71±0.79)years,the mean weight was(12.82±4.83)kg,the mean height was(81.76±12.61)cm,the number of full-term infants was 358(89.5%),the number of premature infants was 42(10.5%),the number of spontaneous deliveries was 202(50.5%),the number of cesarean section was198(49.5%).There were 386 singletons(96.5%),14 multiples(3.5%),216 breastfed(54.0%),152 artificially fed(38.0%),152 mixed fed(38.0%),32 formula fed(8.0%),12food allergens positive(10.4%),the positive rate of inhalation allergens was 86(74.8%),17(14.8%),128(32.0%)without allergic complications,176(44.0%)with simple eczema and 29(7.2%)with simple allergic rhinitis,both were 67(16.8%).2.The control rate of asthma in the experimental group was 22.0%,which was lower than that in the control group(27.5%).There was no significant difference between the two groups(χ~2=1.624,P=0.203).In the first(χ~2=5.827,P=0.016)、second(χ~2=14.509,P<0.001)、third(χ~2=11.927,P=0.001)、fourth(χ~2=57.567,P<0.001)、fifth(χ~2=20.023,P<0.001)、sixth(χ~2=20.027,P<0.001)、seventh(χ~2=10.611,P=0.001)、ninth(χ~2=13.597,P<0.001)、eleventh(χ~2=11.407,P=0.001)、twelfth(χ~2=21.914,P<0.001)months follow-up,the control rate of experimental group was higher than that of control group,the differences were statistically significant.In the eighth(χ~2=0.365,P=0.546)and tenth(χ~2=0.150,P=0.699)months follow-up,the control rate of the test group was higher than that of the control group,the differences was not statistically significant.The frequency of acute asthma attack(U=9460.000,P=0.043),emergency visit(U=9669.500,P=0.033)and hospitalization(U=9748.500,P=0.007)in the experimental group were less than those in the control group.(2)A total of 130 questionnaires were sent out and 122 of them were collected,with a recovery rate of 93.8%.Among them,89 were males and 33 were females.The mean age was(3.98±0.89)years old.Among the parents,15 were males and 107 were females.The mean age was(35.37±21.75)years old.Among the 122 asthma patients,compliance was good in 77 cases(63.1%)and poor in 45 cases(36.9%);there were significant differences in the children’s living place,monthly family income,disease and drug cognition between the two groups(P<0.05).Taking the above three indexes into the binary Logistic regression model,the results showed that high monthly family income(OR=2.690),living in cities(OR=2.309),knowledge of diseases and drugs(OR=2.246)were independent protective factors of compliance.Conclusion:1.In the treatment of children 5 years and younger with asthma,the percentage of patients with better compliance in asthma control is higher.The E-version of the China Children’s asthma action planto home-stay children with asthma can help doctors better judge patients’treatment compliance and asthma control.2.Living in rural areas,low monthly family income,ignorance of disease and drugs as an independent risk factor for increased,decreased compliance with inhaled sugar.In the diagnosis and treatment work,to strengthen the parents asthma related knowledgepropaganda and education,is strengthens the patient self-management,enhances the asthma patient to inhale the sugar cortex treatment compliance the important measure.3.Asthma specialists should be more proactive in emphasizing the importance of asthma action plans and asthma education programs.More research should be done on how to better address health literacy in asthma education programs.