Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Cochin, AP-HP, Paris, France.
Faculté de médecine, Université Grenoble-Alpes, Grenoble, France.
J Asthma. 2022 Apr;59(4):765-774. doi: 10.1080/02770903.2021.1875482. Epub 2021 Feb 13.
In asthma, treatment effectiveness is strongly influenced by the quality of inhaler use. New devices such as Spiromax® have been specifically developed to improve ease of use. It is crucial to determine whether switching to such a device improves inhaler technique and clinical outcomes, and to identify factors associated with handling errors. This observational study assessed inhaler device handling errors in 1435 asthma patients recruited via 135 participating physicians in France, before and after switching therapy from the Symbicort Turbuhaler® or Seretide® Diskus® to DuoResp® Spiromax®. Patients received training in the use of their new device at baseline and were re-assessed after three months. After three months of use, 67% of patients were using the DuoResp® Spiromax® with no handling errors, and 88% with no critical errors. The presence of comorbidities was associated with handling errors overall. Concurrent illness potentially affecting device handling and previous training were associated with critical device handling errors. Most patients (85.4%) preferred DuoResp® Spiromax® over their previous device. Levels of inadequately controlled or uncontrolled asthma were reduced from baseline among patients using DuoResp® Spiromax® (8.6% versus 64.6%), and were higher in patients with critical handling errors. Effective patient education, correct inhaler technique, treatment adherence and devices associated with high patient satisfaction are interrelated factors key to the successful delivery of inhaled asthma therapy. Inhaler technique and patient device satisfaction should be routinely assessed in treated patients with uncontrolled asthma. Supplemental data for this article can be accessed at publisher's website.
在哮喘中,治疗效果受到吸入器使用质量的强烈影响。新的设备,如 Spiromax®,是专门为提高易用性而开发的。确定是否切换到此类设备可以改善吸入器技术和临床结果,并确定与处理错误相关的因素至关重要。这项观察性研究在法国的 135 名参与医生招募的 1435 名哮喘患者中评估了吸入器设备处理错误,在从 Symbicort Turbuhaler®或 Seretide® Diskus®切换到 DuoResp® Spiromax®之前和之后。患者在基线时接受了新设备使用的培训,并在三个月后重新评估。使用三个月后,67%的患者使用 DuoResp® Spiromax®没有处理错误,88%没有关键错误。合并症的存在与整体处理错误有关。同时存在的疾病可能会影响设备的处理,以前的培训与关键设备处理错误有关。大多数患者(85.4%)更喜欢 DuoResp® Spiromax®而不是以前的设备。使用 DuoResp® Spiromax®的患者中,控制不足或不受控制的哮喘水平从基线降低(8.6%比 64.6%),且在有关键处理错误的患者中更高。有效的患者教育、正确的吸入器技术、治疗依从性和与高患者满意度相关的设备是成功提供吸入性哮喘治疗的相互关联的因素。在未控制的哮喘治疗患者中,应定期评估吸入器技术和患者对设备的满意度。本文的补充数据可以在出版商的网站上获取。