Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
Association of Finnish Pharmacies, Helsinki, Finland.
Pulm Pharmacol Ther. 2021 Dec;71:102077. doi: 10.1016/j.pupt.2021.102077. Epub 2021 Sep 15.
The objective of this study was to examine how Inhalation Technique Assessment Service (ITAS) by community pharmacies affect patients' inhalation techniques when using the Respimat® soft mist inhaler. The inhaler was simultaneously updated into a reusable inhaler. The study focused on the Respimat® inhaler because its use is known to be challenging for patients.
The study was performed as a pre-post design in 33 community pharmacies (CPs) in Finland. Patients' inhalation technique was assessed before ITAS (baseline) and immediately after ITAS (follow-up 1). Follow-up 2 was performed when the patient came to the pharmacy for a refill (1-3 months after the baseline and the follow-up 1). A Respimat specific twenty item checklist was used to assess inhalation technique. The checklist included 1) preparation steps before the first use of the Respimat® inhaler (8 items) and 2) daily use steps of the Respimat® inhaler (12 items). After ITAS, the patients received a brief questionnaire to assess their asthma/COPD history.
A total of 228 patients were enrolled at the first visit (mean age 67.8 years, 61.0% female, 85.5% had previous Respimat® use experience) and 42 of them attended the follow-up 2, 1-3 months later (mean age 70.1 years, 69.0% female, 92.9% had previous Respimat® use experience. The median number of the steps performed correctly increased from 17/20 at the baseline to all the 20 steps at the follow-up 1 (p < 0.001). At the baseline, 27.6% of the patients (n = 228) performed all preparation steps correctly, while 87.3% at the follow-up 1 and 71.4% at the follow-up 2. The percentage of the patients with acceptable inhalation technique (all critical daily use steps correct) increased from 69.7% at the baseline to 93.0% at the follow-up 1 (p < 0.001). The corresponding figure at the follow-up 2 was 69.0%. At the baseline, 30.3% of patients had optimal inhalation technique (all daily use steps correct). At the follow-up 1 corresponding figure was 85.1%, and 54.8% at the follow-up 2.
A pharmacist-led intervention significantly improved asthma and COPD patients' inhalation technique with the Respimat® inhaler. Significant improvements were found in the daily use steps and the preparation steps before the first use.
本研究旨在探讨社区药房的吸入技术评估服务（ITAS）如何影响患者使用 Respimat®软雾吸入器时的吸入技术。同时，该吸入器更新为可重复使用的吸入器。该研究专注于 Respimat®吸入器，因为患者使用它具有挑战性。
该研究在芬兰的 33 家社区药房（CPs）中进行了前后设计。在 ITAS 之前（基线）和 ITAS 之后立即（随访 1）评估患者的吸入技术。当患者到药房进行 refill 时进行随访 2（在基线和随访 1 后 1-3 个月）。使用专门的 Respimat 20 项检查表评估吸入技术。检查表包括 1）使用 Respimat®吸入器的首次使用前的准备步骤（8 项）和 2）Respimat®吸入器的日常使用步骤（12 项）。在 ITAS 之后，患者接受了一项简短的问卷以评估他们的哮喘/COPD 病史。
共有 228 名患者在第一次就诊时入组（平均年龄 67.8 岁，61.0%为女性，85.5%有使用过 Respimat®的经验），其中 42 名患者在 1-3 个月后参加了随访 2（平均年龄 70.1 岁，69.0%为女性，92.9%有使用过 Respimat®的经验。执行正确步骤的中位数从基线时的 17/20 增加到随访 1 时的所有 20 个步骤（p<0.001）。在基线时，27.6%的患者（n=228）正确执行了所有准备步骤，而在随访 1 时为 87.3%，在随访 2 时为 71.4%。吸入技术可接受的患者比例（所有关键日常使用步骤正确）从基线时的 69.7%增加到随访 1 时的 93.0%（p<0.001）。在随访 2 时相应的比例为 69.0%。在基线时，30.3%的患者具有最佳的吸入技术（所有日常使用步骤正确）。在随访 1 时，相应的数字为 85.1%，随访 2 时为 54.8%。
药剂师主导的干预措施显著改善了哮喘和 COPD 患者使用 Respimat®吸入器的吸入技术。在日常使用步骤和首次使用前的准备步骤中都发现了显著的改善。
