pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2007-0-5-24-28pulmo-1971Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESВедение больных астмой на первичном уровне здравоохранения: влияние образовательной программы для врачейManagement of asthma patients in primary care settings: effect of a physician's trainingБримкуловН. Н.BrimkulovN. N.

г. Бишкек

ВинниковД. В.VinnikovD. V.

г. Бишкек

РыжковаЕ. В.RyzhkovaE. V.

г. Бишкек

Кыргызско-российский славянский университет; Общественное объединение "Легочное здоровье"Russian FederationОбщественное объединение "Легочное здоровье"Russian FederationКыргызско-российский славянский университетRussian Federation200728102007052428Copyright © Бримкулов Н.Н., Винников Д.В., Рыжкова Е.В., 20072007Бримкулов Н.Н., Винников Д.В., Рыжкова Е.В.Brimkulov N.N., Vinnikov D.V., Ryzhkova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1971

Проведен анализ ведения пациентов до и после краткосрочного обучения вопросам пульмонологии 78 врачей г. Бишкека. Исходно 37 человек (4,1 % от всех болезней органов дыхания) имели диагноз бронхиальной астмы (БА), сразу после обучения — 26, через 1 год — 45 и через 2 года — 26 чел. До обучения пикфлоуметрия и спирометрия не использовались вообще, лечение носило симптоматический характер. В результате обучения повысился уровень теоретических знаний врачей (84,6 % правильных ответов против 73,3 %, p < 0,001), участилось проведение пикфлоуметрии сразу же до 38,5 %, через год — 51,1 %, через 2 года — 38,5 %; спирометрии — 11,5 %, 17,8 % и 26,9 % соответственно. Ингаляционные глюкокортикостероиды (иГКС) были назначены 42,3 %, 53,3 % и 46,2 % пациентов против 5,4 % при исходном обследовании при одновременном снижении необоснованных назначений витаминов, антибиотиков и отхаркивающих препаратов. Проведенное краткосрочное обучение было эффективным, однако следует добиваться 100%-го проведения пикфлоуметрии, подавляющему большинству больных необходимы иГКС. Необходима разработка методов повышения эффективности обучения.

A cross-sectional analysis of management of asthma patients before and after short-term training of 78 physicians in Bishkek was performed. At baseline, diagnosis of asthma was made in 37 patients (4.1 % of all respiratory diseases). Just after training, in 1 year and in 2 years, asthma was diagnosed in 26, 45 and 26 patients, respectively. At baseline, peak flow measurement and spirometry were not used at all and treatment was mainly symptomatic. The training resulted in improvement of theoretical knowledge score from 84.6 % to 73.3 %; p < 0.001. Use of peak flow measurements increased to 38.5 %, 51.1 % and 38.5 % just after the training, in 1 and 2 years, respectively. Use of spirometry grew to 11.5 %, 17.8 % and 26.9 %, respectively. Inhaled corticosteroids (ICS) were administered to 42.3 %, 53.3 %, and 46.2 %, respectively, vs. 5.4 % at baseline with simultaneous reduction in inadequate administrations of vitamins, antibiotics and expectorants. So, the short-term training was effective. However, application of peak flow measurement in 100 % of the patients should be achieved; the majority of patients need ICS. Ways to increase the training efficiency are necessary.

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The authors declare that there are no conflicts of interest present.