Pothirat Chaicharn, Chaiwong Warawut, Limsukon Atikun, Phetsuk Nittaya, Chetsadaphan Nonglak, Choomuang Woranoot, Liwsrisakun Chalerm
Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Asian Pac J Allergy Immunol. 2021 Jun;39(2):96-102. doi: 10.12932/AP-210618-0348.
Inhaler devices are a keystone in the management of asthma during the maintenance phase of treatment.
To evaluate techniques for using inhaler devices in asthma patients.
A prospective cross-sectional study was conducted to assess patient compliance with correct techniques for using inhaler devices across three regimens: pressurized metered-dose inhaler (pMDI), Accuhaler®, and Turbuhaler®. The compliance of patients with essential steps for correct device usage in the case of each regimen was recorded. These were recorded when patients presented for a routine visit and one month after receiving face-to-face training. The percentage of compliance between the use of the devices and the risk factors related to incorrect techniques were analyzed by logistic regression analysis. The percentages of incorrect techniques were compared between the two visits using a Chi-squared test.
A total of 108 asthma patients (35.2% male), with a mean age of 57.5 ± 12.3 years were evaluated. Percentages of incorrect use of Accuhaler®, pMDI, and Turbuhaler® were 50%, 48%, and 55.6%, respectively. The most common incorrectness's is breath out gently to residual volume (approximately one-third). Previous treatment by a pulmonologist for less than 2 years was the single factor related to incorrect technique [Adjusted OR = 2.8 (95%CI, 1.2-6.3), p = 0.02]. Formal training resulted in a statistically significant decrease in percentage of incorrect techniques (52.8% vs. 32.1%, p = 0.02).
Inhalation technique in asthma patients was mostly unsatisfactory, especially in patients who had been treated by a pulmonologist for less than 2 years. Face-to-face training significantly improved good technique in all devices.
吸入装置是哮喘维持治疗阶段管理的关键要素。
评估哮喘患者使用吸入装置的技术。
开展一项前瞻性横断面研究，以评估患者在三种治疗方案中使用吸入装置正确技术的依从性：压力定量吸入器（pMDI）、准纳器®和都保®。记录患者在每种治疗方案下正确使用装置基本步骤的依从性。这些记录在患者进行常规就诊时以及接受面对面培训一个月后进行。通过逻辑回归分析分析装置使用与不正确技术相关危险因素之间的依从率。使用卡方检验比较两次就诊之间不正确技术的百分比。
共评估了108例哮喘患者（男性占35.2%），平均年龄为57.5±12.3岁。准纳器®、pMDI和都保®的不正确使用率分别为50%、48%和55.6%。最常见的错误是轻轻呼气至余气量（约三分之一）。肺病专家既往治疗时间少于2年是与不正确技术相关的单一因素[调整后的比值比=2.8（95%置信区间，1.2 - 6.3），p = 0.02]。正规培训导致不正确技术的百分比有统计学意义的下降（52.8%对32.1%，p = 0.02）。
哮喘患者的吸入技术大多不尽人意，尤其是那些接受肺病专家治疗少于2年的患者。面对面培训显著改善了所有装置的正确使用技术。
