Clarenbach Christian F, Nicod Laurent P, Kohler Malcolm
Division of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
Division of Pulmonology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
J Thorac Dis. 2016 Nov;8(11):3096-3104. doi: 10.21037/jtd.2016.11.95.
The aim of the Asthma Survey was to generate insights about the daily practice of physicians with regard to inhaler devices used for treating asthma under real-world conditions in Switzerland.
A questionnaire was administered to 605 participating hospital- and practice-based Swiss physicians. Areas of interest were practical aspects of patient education, typical difficulties encountered when prescribing pressurized metered-dose inhalers (pMDI) and dry-powder inhalers (DPI), and reasons for physician preferences. Differences between the German-speaking part of Switzerland (D-CH) and French- and Italian-speaking parts of Switzerland (W-CH) linguistic regions were explored.
Datasets from 529 physicians (291 D-CH and 238 W-CH) were suitable for analysis, 342 internists/general practitioners, 177 pulmonologists/allergologists, and 10 other. Approximately 90% of all participants declared being personally involved in providing inhaler device education to their patients. Practice assistants (33.0% . 9.2%, P<0.001) and pharmacists (6.9% . 19.7%, P<0.001) were more frequently involved in D-CH compared to W-CH. Patient skills with regard to inhalation technique were generally not monitored on a regular basis with only 34.0% of participants ensuring such checks at the scheduled visits. DPIs were overwhelmingly preferred over pMDI. Although the prevalence of typical handling errors was similar with both inhalers in the two regions, pMDIs were used more frequently in W-CH (P<0.001).
Real-world asthma management and inhaler preferences differ between D-CH and W-CH. While the importance of patient education is widely acknowledged, inhalation skills monitoring remains suboptimal. The reasons for higher pMDI preference in W-CH compared to D-CH deserve further research.
哮喘调查的目的是深入了解瑞士现实环境中医生在使用吸入器治疗哮喘方面的日常实践情况。
对605名参与调查的瑞士医院及诊所医生进行问卷调查。调查的关注点包括患者教育的实际情况、开具压力定量吸入器（pMDI）和干粉吸入器（DPI）时遇到的典型困难，以及医生偏好的原因。同时探讨了瑞士德语区（D-CH）与瑞士法语区和意大利语区（W-CH）在语言区域上的差异。
来自529名医生（291名德语区医生和238名其他语言区医生）的数据集适合进行分析，其中包括342名内科医生/全科医生、177名肺科医生/过敏症专科医生以及10名其他医生。约90%的参与者表示亲自参与为患者提供吸入器设备教育。与其他语言区相比，德语区的实践助理（33.0%对9.2%，P<0.001）和药剂师（6.9%对19.7%，P<0.001）参与患者教育的频率更高。对于吸入技术，通常没有定期监测患者的技能，只有34.0%的参与者在定期就诊时进行此类检查。与pMDI相比，医生们压倒性地更倾向于DPI。尽管两个地区使用这两种吸入器时典型操作错误的发生率相似，但pMDI在其他语言区的使用频率更高（P<0.001）。
瑞士德语区和其他语言区在现实环境中的哮喘管理及吸入器偏好存在差异。虽然患者教育的重要性得到广泛认可，但吸入技能监测仍未达到最佳状态。其他语言区相比德语区对pMDI有更高偏好的原因值得进一步研究。
