Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.
Department of Chest Diseases, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Int J Clin Pract. 2021 Jun;75(6):e14073. doi: 10.1111/ijcp.14073. Epub 2021 Feb 12.
There is a lack of an overview of determinants of incorrect inhaler technique among chronic obstructive pulmonary diseases (COPD) subjects. The aim of this study was to determine the prevalence and possible determinants of incorrect inhaler technique in COPD subjects with common inhalers.
A cross over study was conducted in 180 COPD subjects. Baseline assessment of inhaler technique was evaluated in 10 placebo inhalers including: [pressurised metered dose inhaler (pMDI), Aerolizer, Handihaler, Turbohaler, Discus, Breezhaler, Ellipta, Easyhaler, Diskhaler and Respimat] without receiving any instructions. Subjects were then crossed over to other inhalers in random order. Inhaler technique was assessed. The proper technique of inhalers was demonstrated and the number of counselling attempts needed to achieve a correct technique was recorded. Patient past-experience, demographics/clinical variables were recorded.
Incorrect inhaler techniques were highly prevalent among COPD subjects, ranging from 80% of participants demonstrated incorrect use, a minimum of 1 error, with Ellipta, to 100% with Respimat/Diskhaler (P < .001). Past-experience (OR = 14.639 at P < .001) and inhaler-type (OR = 10.397 at P < .001, 4.267 at P =. 007, 2.664 at P =. 057, 8.666 at P =. 001, 10.250 at P < .001, 0.613 at P =. 212 and 0.265 at P< .001 for pMDI, Aerolizer, Handihaler, Turbohaler, Discus, Breezhaler and Ellipta, respectively) were the strongest determinants of incorrect technique followed by gender (OR = 0.310 at P < .001), age category (OR = 0.307 at P < .001) and GOLD group (OR = 2.289 at P =. 005).
Incorrect inhaler techniques are highly prevalent among COPD subjects. Lack of past-experience, certain inhaler types, female gender, older age and lower GOLD group are the most significant determinants of incorrect technique.
目前缺乏对慢性阻塞性肺疾病（COPD）患者中不正确吸入器技术的决定因素的全面了解。本研究的目的是确定在使用常见吸入器的 COPD 患者中，不正确吸入器技术的流行程度和可能的决定因素。
在 180 名 COPD 患者中进行了一项交叉研究。在未接受任何指导的情况下，对 10 个安慰剂吸入器（包括：[压力定量吸入器（pMDI）、Aerolizer、Handihaler、Turbohaler、Discus、Breezhaler、Ellipta、Easyhaler、Diskhaler 和 Respimat]）的吸入器技术进行了基线评估。然后，患者随机交叉使用其他吸入器。评估吸入器技术。演示正确的吸入器技术，并记录达到正确技术所需的咨询尝试次数。记录患者过去的经验、人口统计学/临床变量。
在 COPD 患者中，不正确的吸入器技术非常普遍，从最低的 1 个错误（80%的参与者使用 Ellipta 时表现出不正确的使用）到 100%的患者使用 Respimat/Diskhaler（P<.001）。过去的经验（OR=14.639，P<.001）和吸入器类型（OR=10.397，P<.001，4.267，P=.007，2.664，P=.057，8.666，P=.001，10.250，P<.001，0.613，P=.212 和 0.265，P<.001，pMDI、Aerolizer、Handihaler、Turbohaler、Discus、Breezhaler 和 Ellipta）是不正确技术的最强决定因素，其次是性别（OR=0.310，P<.001）、年龄类别（OR=0.307，P<.001）和 GOLD 组（OR=2.289，P=.005）。
不正确的吸入器技术在 COPD 患者中非常普遍。缺乏过去的经验、某些吸入器类型、女性、年龄较大和较低的 GOLD 组是不正确技术的最显著决定因素。
