Kaplan Alan, Price David
Family Physician Airways Group of Canada, University of Toronto, Toronto, ON, Canada.
University of Aberdeen, Aberdeen, UK.
Can Respir J. 2018 May 23;2018:9473051. doi: 10.1155/2018/9473051. eCollection 2018.
Poor inhaler technique and nonadherence impair the efficacy of medications for asthma and chronic obstructive pulmonary disease (COPD). A range of factors, including age, dexterity, inspiratory capacity, cognitive ability, health literacy, and ethnicity, can impact a patient's ability and intention to use their device. Treatment success can also be influenced by patient preferences and perceptions. Therefore, it is important that healthcare professionals effectively match inhaler devices to individual patients' needs and abilities and empower patients by including them in treatment decisions. Physicians must, therefore, fully understand the characteristics of each device, as well as their patients' demographic characteristics and comorbidities. Following device selection, patient training and education, including a physical demonstration of the device, are key to eliminate any critical errors that may impact on health outcomes. Inhaler technique should be frequently rechecked. This review will examine the important role of primary care providers in the selection of appropriate inhaler devices and provision of training for patients with COPD and asthma to optimize correct inhaler use and adherence. An overview of the key features of available devices and of the factors to consider when selecting devices will be provided in the context of current asthma and COPD guidelines.
吸入器使用技术欠佳和不依从会削弱治疗哮喘和慢性阻塞性肺疾病（COPD）药物的疗效。一系列因素，包括年龄、灵活性、吸气能力、认知能力、健康素养和种族，都会影响患者使用吸入装置的能力和意愿。治疗的成功与否还会受到患者偏好和认知的影响。因此，医疗保健专业人员根据个体患者的需求和能力有效匹配吸入器装置，并让患者参与治疗决策以增强其信心，这一点很重要。因此，医生必须充分了解每种装置的特点，以及患者的人口统计学特征和合并症。在选定装置后，对患者进行培训和教育，包括对装置进行实际演示，是消除可能影响健康结果的任何严重错误的关键。应经常重新检查吸入器使用技术。本综述将探讨初级保健提供者在为慢性阻塞性肺疾病和哮喘患者选择合适的吸入器装置以及提供培训以优化正确使用吸入器和提高依从性方面的重要作用。将结合当前哮喘和慢性阻塞性肺疾病指南，概述现有装置的关键特征以及选择装置时应考虑的因素。
