Dhand Rajiv, Mahler Donald A, Carlin Brian W, Hanania Nicola A, Ohar Jill A, Pinto-Plata Victor, Shah Tina, Eubanks David, Braman Sidney S
University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Respir Care. 2018 Jul;63(7):833-839. doi: 10.4187/respcare.05715. Epub 2018 Mar 20.
Successful inhalation therapy depends on the ability of patients with COPD to properly use devices. We explored subjects' COPD knowledge, including education they receive from health care providers, treatment experiences, and practices with inhalation devices.
A multiple-choice online survey, developed by a steering committee of American Thoracic Society clinicians and scientists, was administered to subjects with COPD who were sourced from the Harris Poll Online panel.
Of the 254 respondents (mean age 61.8 y; 49% males), most subjects (82%) claimed to understand their disease and available treatments, yet COPD symptoms and causes were well known to only 45% and 44% of subjects, respectively. Forty-three percent of subjects had ever used a pressurized metered-dose inhaler or dry-powder inhaler. Of the 54% of subjects who had ever used a small-volume nebulizer (SVN), 63% considered this device to be easy to use, 55% considered it to be fast-acting, 53% considered it to be convenient, and 38% considered it to be essential for treatment. Among subjects who had ever used them, SVNs were preferred by 54% over other devices. One third of subjects desired more extensive education during office visits; 25% felt the time was insufficient to cover questions, and 15% felt their concerns about COPD treatment(s) were ignored. Subjects believed physicians (32%), nurses (26%), and no single provider (28%) were primarily responsible for training and assessing proper inhalation technique.
The survey showed differences between patients' beliefs and knowledge of COPD; the need for continuous education from health care providers, particularly on inhalation devices; and extensive use of pressurized metered-dose inhalers and dry-powder inhalers despite positive perceptions of SVNs.
成功的吸入疗法取决于慢性阻塞性肺疾病(COPD)患者正确使用设备的能力。我们探讨了受试者对COPD的了解情况,包括他们从医疗保健提供者那里获得的教育、治疗经历以及使用吸入设备的习惯。
由美国胸科学会临床医生和科学家组成的指导委员会开发的多项选择题在线调查,对来自哈里斯在线民意调查小组的COPD受试者进行了调查。
在254名受访者中(平均年龄61.8岁;49%为男性),大多数受试者(82%)声称了解自己的疾病和可用治疗方法,但分别只有45%和44%的受试者清楚COPD的症状和病因。43%的受试者曾使用过压力定量吸入器或干粉吸入器。在曾使用过小容量雾化器(SVN)的54%的受试者中,63%认为该设备易于使用,55%认为其起效快,53%认为其方便,38%认为其对治疗至关重要。在曾使用过这些设备的受试者中,54%的人更喜欢SVN而不是其他设备。三分之一的受试者希望在门诊就诊时能接受更全面的教育;25%的人觉得时间不足以涵盖所有问题,15%的人觉得他们对COPD治疗的担忧被忽视了。受试者认为医生(32%)、护士(26%)以及没有单一的提供者(28%)主要负责培训和评估正确的吸入技术。
调查显示患者对COPD的认知和了解存在差异;需要医疗保健提供者持续进行教育,尤其是关于吸入设备的教育;尽管对SVN有积极的看法,但压力定量吸入器和干粉吸入器仍被广泛使用。