Malot L, Molimard M, Abouelfatah A, Lignot S, Depont F, Moore N, Fayon M
Département de pédiatrie, centre de recherche (CEDRE), hôpital Pellegrin - Enfants, CHU de Bordeaux, France.
Arch Pediatr. 2007 Oct;14(10):1190-5. doi: 10.1016/j.arcped.2007.06.017. Epub 2007 Jul 19.
The correct use of inhaler devices is important for the efficacy of the treatment of childhood asthma. Few studies have compared the use of inhaler devices in real life, in particular in children.
To determine whether such devices were correctly used in asthmatic children within a primary care setting.
Three hundred and sixty-four children aged 5 to 18 years (mean+/-SD: 14.1+/-3.3) treated for at least 1 month by an inhaler device were included. During a routine visit to the doctor, the primary care physician assessed the childrens' handling of their current device, using a checklist established for each device from the package leaflet.
At least half of the patients made at least 1 error, regardless of the inhaler used. The best result was obtained with the Diskus (46% error-rate) and the worst with the pressurized metered-dose inhaler (pMDI) (78% error-rate). The rank order of increasing critical-error rate (at least 1 error) was as follows: Diskus (6%)<Autohaler (8%)<Aerolizer (9%)<pMDI (24%)<Turbuhaler (26%).
Irrespective of the type of device used, many errors are committed in real-life use. Overall, the Diskus, the Autohaler and the Aerolizer devices are more correctly used than the Turbuhaler or the pMDIs. However, it would be relatively easy to rectify all the errors identified by this study by simple educative measures.
正确使用吸入装置对于儿童哮喘治疗的疗效很重要。很少有研究在现实生活中比较吸入装置的使用情况，尤其是在儿童中。
确定在基层医疗环境中哮喘儿童是否正确使用了此类装置。
纳入364名年龄在5至18岁（平均±标准差：14.1±3.3）、使用吸入装置治疗至少1个月的儿童。在患儿常规就诊时，基层医疗医生使用根据每种装置的药品说明书制定的清单评估患儿对其当前使用装置的操作情况。
无论使用哪种吸入器，至少一半的患者至少出现1次错误。使用都保装置（Diskus）的错误率最低（46%），而使用压力定量吸入器（pMDI）的错误率最高（78%）。严重错误率（至少出现1次错误）由低到高的排序如下：都保装置（6%）＜自动吸入器（Autohaler）（8%）＜雾化吸入器（Aerolizer）（9%）＜压力定量吸入器（24%）＜准纳器（Turbuhaler）（26%）。
无论使用何种装置，在实际使用中都会出现许多错误。总体而言，都保装置、自动吸入器和雾化吸入器的使用比准纳器或压力定量吸入器更正确。然而，通过简单的教育措施相对容易纠正本研究中发现的所有错误。
