Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Chest. 2020 Jun;157(6):1466-1477. doi: 10.1016/j.chest.2019.12.034. Epub 2020 Jan 22.
COPD is a common respiratory disorder that poses a major health-care burden with societal and financial ramifications. Although effective inhaled therapies are available, nonadherence is common among patients with COPD and potentially contributes to the burden of this disease. Electronic inhaler monitoring (EIM) is a novel modality that enables real-time assessment of adherence to inhaled therapy and informs the assessment of treatment effectiveness. EIM can be combined with physician feedback, automated audiovisual reminders, and text messaging to bolster adherence. Clinical studies have suggested that EIM can diagnose nonadherence, improve adherence, and predict exacerbations. Using an EIM-guided protocol has the potential to avoid treatment escalation in the nonadherent. Coupling EIM to behavioral intervention is an area of ongoing research with mixed results, with some studies showing benefit and others showing minimal or no significant change in clinical outcomes. Further investigation is necessary to understand the incremental benefits of EIM features, delineate optimal program implementation, and target patient populations that would benefit the most from monitoring.
COPD 是一种常见的呼吸系统疾病，给医疗保健带来了重大负担，并对社会和经济产生影响。虽然有有效的吸入疗法，但 COPD 患者普遍存在不遵医嘱的情况，这可能是导致该疾病负担的一个因素。电子吸入器监测（EIM）是一种新的模式，可以实时评估吸入治疗的依从性，并为评估治疗效果提供信息。EIM 可以与医生反馈、自动视听提醒和短信相结合，以提高依从性。临床研究表明，EIM 可以诊断不依从，提高依从性，并预测恶化。使用 EIM 指导的方案有可能避免不依从患者的治疗升级。将 EIM 与行为干预相结合是一个正在进行的研究领域，结果喜忧参半，一些研究显示有益，而另一些研究显示在临床结果方面几乎没有或没有显著变化。需要进一步研究来了解 EIM 功能的附加益处，确定最佳方案实施，并确定最受益于监测的患者人群。
