日本における喘息患者実態電話調査2005年  [in Japanese] ASTHMA INSIGHTS & REALITY IN JAPAN 2005  [in Japanese]

【目的】喘息患者の実態を調査し,喘息症状,喘息の管理状況,吸入ステロイド薬の使用率とガイドラインの達成度を確認する.【方法】2005年9月から12月にかけて全国一般世帯を対象に,無作為に電話インタビューによるアンケート調査を実施した.【結果】成人喘息患者(平均52.2歳),小児喘息患者(平均8.4歳)の保護者各400例を解析対象とした.最近1カ月間で日中に喘息症状があった患者は4割以上,夜間覚醒を伴う喘息症状は3割以上であり,成人と小児を合算した最近1年間の喘息エピソードは入院,救急治療室受診,予定外受診,欠勤・欠席など各々7%,4%,33%,29%であった.吸入ステロイド薬使用率は成人18%,小児8%であり,患者のピークフロー認知率および肺機能検査経験率は低かった.【結語】喘息エピソードを経験した患者の割合は2000年度調査より減少し,吸入ステロイド薬使用率は増加したが,いまだわが国のガイドラインが目標とする喘息管理状況には至っていない.第一線の医療へのより一層のガイドライン浸透が今後の課題である.

Background: This Asthma Insights & Reality in Japan survey was conducted to access the achievement of asthma control by patients and current status of asthma treatment in 2005. Methods: This was cross-sectional, randomized- digit-dial household telephone survey, conducted between September and December 2005. Results: A total 400 adults (mean 52.2 years) and 400 parents of children (mean 8.2 years) with asthma were interviewed by telephone. More than 40% of these patients reported having daytime asthma symptoms and over 30% in nighttime symptoms with awakening. Asthma episodes, i.e. hospitalization, emergency room visit, unscheduled visit, work/school absence were observed in 7, 4, 33, 29% of total patients during the past year, respectively. Eighteen percent of adult and 8% of children were used inhaled corticosteroid. Awareness of peak-flow meter and experience of lung function test were low. Conclusion: The rate of patients who experienced asthma symptoms or episodes were tended to decrease, and use of inhaled corticosteroids seemed to be increased since 2002 when a similar survey took place. However, asthma remains poorly controlled and the current level is still far from achieving the goal of asthma management objected by the Japanese guidelines. Further dissemination of standardize therapy in compliance with the guideline is required.