General Practitioner and Respiratory Lead, Harrow, London, UK.
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
NPJ Prim Care Respir Med. 2016 Apr 21;26:16017. doi: 10.1038/npjpcrm.2016.17.
Health professionals tasked with advising patients with asthma and chronic obstructive pulmonary disease (COPD) how to use inhaler devices properly and what to do about unwanted effects will be aware of a variety of commonly held precepts. The evidence for many of these is, however, lacking or old and therefore in need of re-examination. Few would disagree that facilitating and encouraging regular and proper use of inhaler devices for the treatment of asthma and COPD is critical for successful outcomes. It seems logical that the abandonment of unnecessary or ill-founded practices forms an integral part of this process: the use of inhalers is bewildering enough, particularly with regular introduction of new drugs, devices and ancillary equipment, without unnecessary and pointless adages. We review the evidence, or lack thereof, underlying ten items of inhaler 'lore' commonly passed on by health professionals to each other and thence to patients. The exercise is intended as a pragmatic, evidence-informed review by a group of clinicians with appropriate experience. It is not intended to be an exhaustive review of the literature; rather, we aim to stimulate debate, and to encourage researchers to challenge some of these ideas and to provide new, updated evidence on which to base relevant, meaningful advice in the future. The discussion on each item is followed by a formal, expert opinion by members of the ADMIT Working Group.
医疗专业人员在为哮喘和慢性阻塞性肺疾病（COPD）患者提供建议时，需要告知他们如何正确使用吸入器装置以及如何应对不良反应。他们会了解到许多常见的既定观念。然而，这些观念中的许多观念的证据是缺乏的或者是陈旧的，因此需要重新审查。很少有人会不同意，为了取得成功的治疗结果，促进和鼓励哮喘和 COPD 患者经常且正确地使用吸入器装置是至关重要的。放弃不必要或没有根据的做法似乎是这个过程的一个组成部分：使用吸入器已经够令人困惑的了，特别是随着新药、新设备和辅助设备的不断推出，没有必要和无意义的陈词滥调。我们审查了十项吸入器“传说”背后的证据，这些传说通常是由医疗专业人员相互传递，然后再传递给患者的。这项工作是由一组具有相关经验的临床医生进行的务实的、基于证据的审查。这并不是对文献的详尽回顾；相反，我们旨在引发辩论，并鼓励研究人员对其中一些观点提出质疑，并提供新的、更新的证据，以便为未来提供相关的、有意义的建议。在对每一项进行讨论后，ADMIT 工作组的成员会给出正式的专家意见。
