哮喘患者使用吸入器装置、给药技术及吸入性糖皮质激素的依从性
Inhaler device, administration technique, and adherence to inhaled corticosteroids in patients with asthma.
作者信息
Roy Angkana, Battle Kayleigh, Lurslurchachai Linda, Halm Ethan A, Wisnivesky Juan P
机构信息
Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA.
出版信息
Prim Care Respir J. 2011 Jun;20(2):148-54. doi: 10.4104/pcrj.2011.00022.
AIM
To compare inhaled corticosteroid (ICS) inhaler type with user technique and ICS medication adherence among adults with asthma.
METHODS
We classified 270 adults into two groups by ICS device type: metered-dose inhaler (MDI) or dry powder inhaler (DPI). Inhaler technique was assessed using standardised checklists. Medication adherence was evaluated using the Medication Adherence Report Scale (MARS). Differences in inhaler technique and MARS score among patients using MDIs versus DPIs were evaluated.
RESULTS
Univariate analysis showed no difference in technique scores between the groups (p=0.46), but better ICS adherence among DPI users (p=0.001). In multivariable analysis, DPI use remained significantly associated with higher rates of adherence (OR 2.2; 95% CI 1.2 to 3.8) but not with inhaler technique (-0.2; 95% CI -0.5 to 0.1) after adjusting for potential confounders.
CONCLUSIONS
Type of inhaler device appears to be associated with adherence to asthma controller medications. Prospective studies are needed to elucidate further the potential effect of the type of ICS delivery device on asthma self-management.
目的
比较成人哮喘患者使用的吸入性糖皮质激素（ICS）吸入器类型、使用技术及ICS药物依从性。
方法
我们根据ICS装置类型将270名成年人分为两组：定量吸入器（MDI）或干粉吸入器（DPI）。使用标准化检查表评估吸入器技术。使用药物依从性报告量表（MARS）评估药物依从性。评估使用MDI与DPI的患者在吸入器技术和MARS评分方面的差异。
结果
单因素分析显示两组之间技术得分无差异（p = 0.46），但DPI使用者的ICS依从性更好（p = 0.001）。在多变量分析中，在调整潜在混杂因素后，使用DPI仍与更高的依从率显著相关（比值比2.2；95%置信区间1.2至3.8），但与吸入器技术无关（-0.2；95%置信区间-0.5至0.1）。
结论
吸入器装置类型似乎与哮喘控制药物的依从性有关。需要进行前瞻性研究以进一步阐明ICS给药装置类型对哮喘自我管理的潜在影响。
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