Ho Shu F, OMahony M Sinead, Steward John A, Breay Patricia, Burr Michael L
Royal Shrewsbury Hospital, Shrewsbury, Shropshire SY3 8XQ, UK.
Age Ageing. 2004 Mar;33(2):185-8. doi: 10.1093/ageing/afh062.
Good inhaler technique and medication concordance is important for symptom and disease control in chronic airways disease.
Establish the prevalence of inhaler use; the main inhaler devices used by older people at home; their ability to use the inhalers they have been prescribed; and the relationship between perceived ease of use and actual performance.
Cross-sectional population based study.
Subjects aged 70 years and over living at home.
500 subjects were randomly selected from 5002 subjects aged 70 years and over living at home. Inhalers used over the previous 24 hours were identified by a nurse on home visit. Those with cognitive impairment were excluded. Inhaler system was assessed and graded by a doctor as acceptable (perfect or minor errors) or unacceptable (major errors), using previously published criteria. Perceived ease of use of the device was rated as easy, moderate or difficult.
423 subjects participated in the study. The population prevalence of inhaler use was 15.8% (12.0, 19.7). Of the 91 inhaler devices used, 39 (42.8%) were metered dose inhalers, 34 (37.4%) were metered dose inhalers with large volume spacers, and 18 (19.8%) were breath-actuated devices. Thirty-two subjects (82.1%) using metered dose inhalers had an acceptable technique compared with 33 (97.1%) of those using metered dose inhalers with large volume spacers and 13 (72.2%) of those using breath-actuated devices (P < 0.05). Up to three quarters of inhalers were considered easy to use but 12% of subjects who rated their inhaler device as being easy to use made major errors.
Metered dose inhaler was the most frequently prescribed inhaler and was used correctly by most subjects especially in combination with large volume spacers. Major errors were more common with breath-actuated devices. Inhaler technique should be checked as patients' perception of their inhaler skills correlates poorly with actual performance.
良好的吸入器使用技术和药物依从性对于慢性气道疾病的症状和疾病控制至关重要。
确定吸入器的使用 prevalence；老年人在家中使用的主要吸入器装置；他们使用所开处方吸入器的能力；以及感知易用性与实际操作之间的关系。
基于人群的横断面研究。
70岁及以上居家生活的老年人。
从5002名70岁及以上居家生活的老年人中随机选取500名受试者。护士通过家访确定过去24小时内使用的吸入器。排除有认知障碍的受试者。医生根据先前发表的标准将吸入器使用系统评估为可接受（完美或轻微错误）或不可接受（重大错误）。将装置的感知易用性评为容易、中等或困难。
423名受试者参与了研究。吸入器使用的人群患病率为15.8%（12.0，19.7）。在使用的91个吸入器装置中，39个（42.8%）是定量吸入器，34个（37.4%）是带大容量储雾罐的定量吸入器，18个（19.8%）是呼吸驱动装置。使用定量吸入器的32名受试者（82.1%）技术可接受，而使用带大容量储雾罐的定量吸入器的受试者中有33名（97.1%），使用呼吸驱动装置的受试者中有13名（72.2%）（P<0.05）。高达四分之三的吸入器被认为易于使用，但12%将其吸入器装置评为易于使用的受试者出现了重大错误。
定量吸入器是最常处方的吸入器，大多数受试者使用正确，尤其是与大容量储雾罐联合使用时。呼吸驱动装置出现重大错误更为常见。应检查吸入器使用技术，因为患者对其吸入器技能的感知与实际操作相关性较差。
