Centre Hospitalier Universitaire Saint-Pierre, Department of Pneumology , Rue Haute, 322, B-1000 Brussels , Belgium +32 02 535 42 03 ; +32 02 535 33 62 ;
Expert Opin Drug Deliv. 2014 Mar;11(3):313-23. doi: 10.1517/17425247.2014.872626. Epub 2013 Dec 18.
The study aimed to assess usage of inhalation devices in asthma and chronic obstructive pulmonary disease (COPD).
In this two-round Delphi survey, 50 experts in asthma and COPD completed a 13-item, Internet-based, self-administered questionnaire about choice of inhalation device, training and monitoring of inhalation techniques, the interchangeability and the role of costs in the selection of inhalation devices. For each item, the median (central tendency) and interquartile ranges (degree of consensus) were calculated.
Experts considered that the choice of inhalation device was as important as that of active substance (very good consensus) and should be driven by ease of use (good to very good consensus) and teaching (very good consensus). Experts recommended giving oral and visual instructions (good consensus) and systematic monitoring inhalation techniques. Pulmonologists and paramedics have predominantly educational roles (very good consensus). Experts discouraged inhalation device interchangeability (good consensus) and switching for cost reasons (good to very good consensus) without medical consultation (good consensus).
The results of this survey thus suggested that inhalation devices are as important as active substances and training and monitoring are essential in ensuring effective treatment of asthma and COPD. Inhalation device switching without medical consultation should be avoided.
本研究旨在评估吸入装置在哮喘和慢性阻塞性肺疾病（COPD）中的使用情况。
在这项两轮德尔菲调查中，50 名哮喘和 COPD 专家完成了一项关于吸入装置选择、吸入技术培训和监测、可互换性以及成本在吸入装置选择中的作用的 13 项基于互联网的自我管理问卷。对于每个项目，计算中位数（集中趋势）和四分位距（共识程度）。
专家认为吸入装置的选择与活性物质一样重要（非常好的共识），并且应该由易用性（良好到非常好的共识）和教学（非常好的共识）驱动。专家建议提供口头和视觉说明（良好的共识）以及系统监测吸入技术。肺科医生和辅助医务人员主要承担教育角色（非常好的共识）。专家不鼓励吸入装置的可互换性（良好的共识）和出于成本原因（良好到非常好的共识）而不进行医疗咨询的切换（良好的共识）。
因此，这项调查的结果表明，吸入装置与活性物质同样重要，培训和监测对于确保哮喘和 COPD 的有效治疗至关重要。没有医疗咨询就不应进行吸入装置的更换。
