Vitacca M, Paneroni M, Fracassi M, Mandora E, Cerqui L, Benedetti G, Zanoni C, Pluda A, Bertacchini L, Fiorenza D
Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy.
Respiratory Rehabilitation of the Institute of Lumezzane. Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy.
Pulmonology. 2023 Mar-Apr;29(2):130-137. doi: 10.1016/j.pulmoe.2020.04.010. Epub 2020 Nov 29.
Patients present poor knowledge and skills about their respiratory disease and inhaler device. We aimed to: (1) evaluate COPD and asthmatic patients... ability to manage inhaled drugs (2) identify differences among devices and (3) correlate clinical data with patient ability.
Patients (n=134) admitted for pulmonary rehabilitation (PR) were given an ad-hoc questionnaire covering 0% as the worst and 100% the best value of global ability (indicating the sum of knowledge and skills in managing inhaled drugs) at baseline (T0) and discharge (T1). Educational program was provided during PR. Setting of rehabilitation, age, sex, diagnosis, spirometry, CIRS score, level of autonomy to use medications, if na..ve about PR, educational level, and number/type of prescribed inhaled drugs were recorded.
Most patients used 1 drug while 37% used 2 drugs. DPIs were the main device prescribed. At baseline, patients... mean level of knowledge and skills were 73% and 58%, respectively. There was a significant difference in level of skills (p=0.046) among device families, DPIs resulting worst and pMDIs best. Global ability, skills and knowledge improved after educational support (p<0.001) but did not reach the optimal level, 88%, 87% and 89%, respectively. Baseline global ability was positively correlated to female gender, younger age, previous PR access, outpatient status, higher education level and GOLD D class.
At hospital admission, global ability was not optimal. Education may improve this, irrespective of the type of device used, in particular in male, elderly, na..ve to PR, low educational level patients.
患者对自身呼吸系统疾病及吸入装置的知识和技能掌握较差。我们旨在：（1）评估慢性阻塞性肺疾病（COPD）和哮喘患者……管理吸入药物的能力；（2）识别不同装置之间的差异；（3）将临床数据与患者能力相关联。
对因肺康复（PR）入院的134例患者在基线期（T0）和出院时（T1）进行了一份专门设计的问卷，问卷涵盖全球能力最差为0%、最佳为100%（表示管理吸入药物的知识和技能总和）。在肺康复期间提供了教育项目。记录康复环境、年龄、性别、诊断、肺功能测定、CIRS评分、使用药物的自主程度、是否初次接受肺康复、教育水平以及所开具吸入药物的数量/类型。
大多数患者使用1种药物，37%的患者使用2种药物。干粉吸入器（DPI）是主要开具的装置。在基线期，患者……知识和技能的平均水平分别为73%和58%。不同装置类别之间的技能水平存在显著差异（p = 0.046），干粉吸入器最差，压力定量吸入器（pMDI）最佳。经过教育支持后，全球能力、技能和知识均有所提高（p < 0.001），但未达到最佳水平，分别为88%、87%和89%。基线全球能力与女性性别、较年轻年龄、既往接受过肺康复、门诊状态、较高教育水平和GOLD D级呈正相关。
入院时，全球能力并非最佳。教育可改善这种情况，无论使用何种装置类型，尤其是男性、老年、初次接受肺康复、教育水平低的患者。
