Öztürk Can, Aldağ Yağmur, Yılmaz Demirci Nilgün
Department of Chest Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey.
Tuberk Toraks. 2017 Jun;65(2):69-79. doi: 10.5578/tt.54112.
Inhaled medications are used in chronic airway disease including chronic obstructive pulmonary disease (COPD) and give the opportunity of low doses, lower side effects, and fast effectiveness. Inhaler devices are frequently used incorrectly by patients. Today, it is generally accepted that poor device use is one of the reasons for poor disease control and low adherence. The aim of the study was to investigate a sample of patients with COPD prescribed with inhaled medication and to evaluate the frequency and pattern of incorrect inhaler use as well as affecting factors.
One hundred and eighty consecutive patients who attended the outpatient clinic with the diagnosis of COPD and were prescribed and receiving different types of inhaler drugs at least for one month were included. The patient's ability to use the devices according to steps was scored face to face after they had replied a questionnaire consisting of 26 questions about their inhaler training and disease specifications. The parameters that may affect incorrect use, pattern of incorrect use, characteristics of the patients who experienced incorrect use, and impact of training were evaluated. Chi-Square and Fisher's Exact test were used for statistical analysis.
The rate of correct use including all steps was 26.3% for metered-dose inhaler (pressurized MDI), 30.4% for inhalation capsule aerolizer, 40.5% for diskus, and 46.3% for turbuhaler. The parameters affecting correct use and number of critical errors causing insufficient drug inhalation were type and duration of initial training due to inhaler devices and also duration and stage of the disease.
COPD patients who were prescribed an inhaler drug should be regularly checked and re-trained during out-patient visits on how to use the inhaler device correctly step by step.
吸入药物用于慢性气道疾病,包括慢性阻塞性肺疾病(COPD),具有低剂量、低副作用和起效快的特点。患者经常错误使用吸入器装置。如今,普遍认为装置使用不当是疾病控制不佳和依从性低的原因之一。本研究的目的是调查一组开具吸入药物的COPD患者样本,评估不正确吸入器使用的频率和模式以及影响因素。
纳入180例连续就诊于门诊、诊断为COPD且已开具并接受不同类型吸入药物至少1个月的患者。在患者回答了一份由26个关于其吸入器训练和疾病特征的问题组成的问卷后,当面根据步骤对其使用装置的能力进行评分。评估了可能影响不正确使用的参数、不正确使用的模式、经历不正确使用的患者特征以及训练的影响。采用卡方检验和Fisher精确检验进行统计分析。
定量吸入器(压力型MDI)包括所有步骤的正确使用率为26.3%,吸入胶囊雾化器为30.4%,都保为40.5%,准纳器为46.3%。影响正确使用的参数以及导致药物吸入不足的关键错误数量是吸入器装置的初始训练类型和持续时间,以及疾病的持续时间和阶段。
开具吸入药物的COPD患者在门诊就诊时应定期接受检查,并就如何正确逐步使用吸入器装置进行重新培训。