Padmanabhan Manjulakshmi, Tamilarasu Kadhiravan, Rajaram Manju, Batmanabane Gitanjali
Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Adv Respir Med. 2019;87(4):217-225. doi: 10.5603/ARM.a2019.0021.
Dry powder inhalers (DPI) have been in use in the treatment of chronic respiratory diseases for decades. DPIs require proper inhaler technique to ensure appropriate dose delivery to the lungs which in turn provides disease control and hence reduces the economic burden due to frequent acute attacks and hospital visits. Inadequate inhaler technique remains an everlasting problem among patients with chronic respiratory disease. Hence the aim is to assess the inhaler technique in patients using DPI and to determine the factors associated with inhaler technique.
A cross-sectional study was conducted and 385 patients with asthma or chronic obstructive pulmonary disease (COPD) were recruited. Patient-related and disease-related factors were noted. Severity of the disease were assessed using asthma control test/COPD assessment test questionnaire and spirometer. The investigator assessed the inhaler technique of the patient against standard checklist.
Nearly 46.2% of the patients performed incorrect inhaler technique. Multivariate analysis showed factors like young age [Odd's ratio (OR) 4.13, CI 1.31-17.8], well controlled disease (OR 2, CI 1.1-3.65), and the patients who learnt the technique from a medical personnel (OR 3.67, CI 1.46-9.24) had better inhaler technique.
This study shows that the proper use of inhaler is still an unattained goal and significance of correct use has to be reiterated.
干粉吸入器（DPI）已用于治疗慢性呼吸道疾病数十年。DPI需要正确的吸入技术以确保将适当剂量输送至肺部，进而实现疾病控制，从而减轻因频繁急性发作和就医带来的经济负担。吸入技术不足仍是慢性呼吸道疾病患者长期存在的问题。因此，本研究旨在评估使用DPI患者的吸入技术，并确定与吸入技术相关的因素。
开展一项横断面研究，招募了385例哮喘或慢性阻塞性肺疾病（COPD）患者。记录患者相关因素和疾病相关因素。使用哮喘控制测试/COPD评估测试问卷及肺活量计评估疾病严重程度。研究者对照标准检查表评估患者的吸入技术。
近46.2%的患者吸入技术不正确。多因素分析显示，年龄较小[比值比（OR）4.13，可信区间（CI）1.31 - 17.8]、疾病控制良好（OR 2，CI 1.1 - 3.65）以及从医务人员处学习该技术的患者（OR 3.67，CI 1.46 - 9.24）吸入技术更好。
本研究表明，正确使用吸入器仍是一个未实现的目标，必须重申正确使用的重要性。
