Takemura Masaya, Mitsui Katsumi, Ido Masako, Matsumoto Masataka, Koyama Misuzu, Inoue Daiki, Takamatsu Kazufumi, Itotani Ryo, Ishitoko Manabu, Suzuki Shinko, Aihara Kensaku, Sakuramoto Minoru, Kagioka Hitoshi, Fukui Motonari
Respiratory Disease Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
J Asthma. 2012 Jun;49(5):535-41. doi: 10.3109/02770903.2012.663847. Epub 2012 Mar 5.
The availability of many types of inhalers in the treatment of asthma has resulted in a wide range of prescription choices for clinicians. With so many devices available, however, there is some confusion regarding their proper use among both medical staff and patients. Since 2007, Kitano Hospital and Kita-ku Pharmaceutical Association, Osaka, Japan, have provided a network system for delivering instruction on correct inhalation technique through community pharmacists. We examined the clinical effects of this network system.
Our measurements included the manner in which community pharmacists instruct patients with asthma, the frequency of asthma exacerbations, patients' adherence to inhalation therapy using a 5-point Likert scale questionnaire, and patients' health status both prior to this system and at 4 years after.
Usable information was obtained from 53 community pharmacists and 146 patients with asthma at baseline and from 60 community pharmacists and 148 patients at 4 years. When compared with baseline values, significant improvement was found in pharmacists' instruction and significant decreases were observed in the frequency of asthma exacerbations (1.4 ± 1.6 vs. 1.0 ± 1.4 times/yr, p = .042) and emergency room visits (0.5 ± 1.0 vs. 0.2 ± 0.5 times/yr, p = .004). Adherence to the inhalation regimen significantly increased (4.0 ± 0.7 vs. 4.2 ± 0.8, p = .041), but health status was unchanged.
Our network system may improve asthma control and adherence to inhalation regimens.
多种类型的吸入器可用于治疗哮喘,这为临床医生提供了广泛的处方选择。然而,由于有如此多的设备可供使用,医护人员和患者在正确使用方面都存在一些困惑。自2007年以来,日本大阪北野医院和北区药剂师协会通过社区药剂师提供了一个网络系统,用于提供正确吸入技术的指导。我们研究了这个网络系统的临床效果。
我们的测量包括社区药剂师指导哮喘患者的方式、哮喘发作的频率、患者使用5点李克特量表问卷对吸入治疗的依从性,以及该系统实施前和实施4年后患者的健康状况。
在基线时从53名社区药剂师和146名哮喘患者那里获得了可用信息,4年后从60名社区药剂师和148名患者那里获得了信息。与基线值相比,药剂师的指导有显著改善,哮喘发作频率(1.4±1.6次/年 vs. 1.0±1.4次/年,p = 0.042)和急诊室就诊次数(0.5±1.0次/年 vs. 0.2±0.5次/年,p = 0.004)显著减少。吸入治疗方案的依从性显著提高(4.0±0.7 vs. 4.2±0.8,p = 0.041),但健康状况没有变化。
我们的网络系统可能会改善哮喘控制和吸入治疗方案的依从性。