Investigation and analysis of related factors of non-conformal drugs used in bronchial asthma patients (2011)

Objective To investigate the sources, transmission and use of non-conformal bronchial asthma (asthma) drugs, analyze the related factors of the causes and existences, and put forward some suggestions to restrain the use of these drugs. Methods Patients treated in Weifang Asthma Hospital from May 2008 to April 2010 were investigated about their sources of non-formal drugs, history of accepting standard treatment, termination reasons and so on by the questionnaire interview. The xamination items on these patients included plasmatic cortisol (COR), bone mineral density (BMD) , and composition of the drugs by high pressure liquid chromatograph (HPLC) and MR spectroscopy (MRS). Results ①The situations of patients treated with non-formal drugs: 1 044 patients have accepted nonformal asthma drugs, making up 29. 19% of total inpatients in the orresponding period, while the oldest patients were 78 years old and the youngest were 6 years old. Most of these patients were rural residents (56.70%), low education level (primary educational and lower were 38.60%), no income and lowincome (accounting for 71. 45%). ②Status of non-formal drugs:the non-formal drug came from different regions of China, but predominantly from Henan province (accounting for 70.01%), and then Hebei province, Shandong province, Beijing, and Shanxi province etc. Drugs were bought by mail or in country clinics and country markeplaces, and the news were got from other patients, some country doctors or the advertising. Most of the drug were made into capsule, and the name were related to the function which were marked Pure Chinese Medicine or Home Remedy and so on. Reference Numbe：some of the drugs had fake qualifies for health-tax credit and non marked. These drugs were different in price, with the lowest medicine fee 18 yuan every month, and most of them were less than 100 yuan every month (accounting for 78.1%), but some individual drugs were expensive and attained thousands yuan per package. Most of these drugs contained Glucocorticoids, that is to say, one should eat 10 to 40 mg prednisone one day. ③ The adverse reaction of these drugs involved fat, hirsutism, purple lines,hypertension, diabetes, fractures and so on. ④The results of COR and BMD were lower than the nomal,which were 85. 44% and 67.72% , respectively. ⑤History of accepting standard treatment:22. 22% of all the subject had tried standard treatment, 17.16% of which had used ICS+LABA. The reasons of patients abandoned standard treatment were in sequence of the high drug price, fearing for side effects of hormone,ineffective treatment, and non-convenient etc. The correct methods of inhalation: 12.07% of the patients can use the drug correctly. How to get the correct methods of inhalation: 37.5% of the patients learned the correct method from doctors or nurses-only 16.8% of them learned how to use the drug from doctors or nurses when they were buying it. Conclusions There are various reasons for the causes and existences of the non-formal drugs which do harm to the public. It is necenssary for doctors,patients, and the government to make efforts to prevent the manufacture, sale and transmission of nonformal drugs.

Key words: 
Bronchial asthma;  Non-formal drugs; investigation