Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam.
Int J Environ Res Public Health. 2019 Jan 10;16(2):185. doi: 10.3390/ijerph16020185.
Sub-optimal chronic obstructive pulmonary disease (COPD) management has been found largely due to patients' medication non-adherence and incorrect inhaler technique. This study aimed to examine inhaler use technique and medication adherence among Vietnamese COPD patients as well as potential associated factors. A cross-sectional study involving 70 COPD exacerbators was conducted. Inhaler technique and adherence were evaluated by the 10-item and 12-item Test of Adherence to Inhaler (TAI). Data on the history of COPD, home prescription of inhalers and duration of hospitalization were also collected. Generalized linear regression models were used to determine the associated factors with inhaler use and medication adherence. The results showed that the proportion of patients with good inhaler technique was 22.7% for metered-dose inhalers (MDI), 30.4% for dry powder inhalers (DPI) and 31.8% for soft-mist inhalers (SMI). Full exhalation was the most common mistake. The rates of non-compliance patterns were: "ignorant" (77.1%), "sporadic" (58.6%), and "deliberate" (55.7%). Worse dyspnea, greater health condition impairment, and an increased frequency of exacerbations and hospitalizations were found to be associated negatively with correct inhaler use and treatment adherence. Instructions to COPD patients about using inhalers should focus on correct inhaler technique and adherence even when feeling healthy.
慢性阻塞性肺疾病(COPD)管理不理想的情况主要归因于患者用药不依从和不正确的吸入器使用技术。本研究旨在研究越南 COPD 患者的吸入器使用技术和用药依从性,以及潜在的相关因素。本研究采用横断面研究,共纳入 70 例 COPD 加重患者。使用 10 项和 12 项吸入器依从性测试(TAI)评估吸入器技术和依从性。还收集了 COPD 病史、家庭处方吸入器和住院时间的数据。使用广义线性回归模型确定与吸入器使用和药物依从性相关的因素。结果显示,MDI、DPI 和 SMI 的良好吸入器技术比例分别为 22.7%、30.4%和 31.8%。完全呼气是最常见的错误。不依从模式的发生率分别为:“无知”(77.1%)、“偶尔”(58.6%)和“故意”(55.7%)。更严重的呼吸困难、更大的健康状况损害,以及更频繁的加重和住院与正确使用吸入器和治疗依从性呈负相关。即使感觉健康,也应向 COPD 患者提供关于使用吸入器的正确吸入器技术和依从性的指导。