Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pa.
National Research Network, American Academy of Family Physicians, Leawood, Kan; Department of Family Medicine, University of Colorado, Aurora, Colo.
J Allergy Clin Immunol Pract. 2022 Feb;10(2):517-524.e2. doi: 10.1016/j.jaip.2021.10.016. Epub 2021 Oct 18.
Generally, a short-acting beta-2 agonist (SABA) delivered via metered-dose inhaler (MDI) is recommended for quick relief of asthma symptoms. However, in the PeRson EmPowered Asthma RElief (PREPARE) pragmatic trial, 67% of patients reported having used a nebulizer for SABA administration.
To understand preferences, experiences, and decision making regarding the use of nebulizers in Black and Latinx adults with uncontrolled asthma.
We interviewed 40 of the 1,201 PREPARE patients employing a matrix analysis. Those interviewed were Black (n = 20) and Latinx (n = 20) adults with uncontrolled asthma seeking primary or specialty care in clinics throughout the United States. Data were analyzed used a Rapid Assessment Procedures qualitative methodology, informed by grounded theory.
Substudy participants, on average, reported using a nebulizer 3.5 times/wk. Daily use was common, and frequency ranged from less than daily to up to 6 times daily. Nearly all participants reported a longstanding history of nebulizer use. Participants tended to use their nebulizer at home, and some shared it with others in the home. Many reported preferring a nebulizer over an MDI for relief of severe symptoms and to avoid emergency room visits or hospitalizations. The extent to which cost affected nebulizer use varied among participants.
Despite asthma guideline recommendations that MDIs be used rather than nebulizers for SABA administration, nebulizer use was common among PREPARE study participants. Clinicians should explore patients' history and experiences with nebulizer use as part of evaluation of asthma control.
一般来说，推荐使用短效β2 受体激动剂（SABA）通过计量吸入器（MDI）快速缓解哮喘症状。然而，在 PeRson EmPowered Asthma RElief（PREPARE）实用临床试验中，67%的患者报告使用雾化器进行 SABA 给药。
了解黑人和拉丁裔成年人在未控制的哮喘中使用雾化器的偏好、经验和决策。
我们对 PREPARE 试验中的 1201 名患者中的 40 名进行了访谈，采用矩阵分析。接受采访的患者为黑人和拉丁裔成年人，患有未控制的哮喘，在美国各地的诊所寻求初级或专科护理。使用快速评估程序定性方法（受扎根理论启发）分析数据。
子研究参与者平均每周使用雾化器 3.5 次。每日使用很常见，频率从每日少于一次到每日 6 次不等。几乎所有参与者都报告了长期使用雾化器的历史。参与者倾向于在家中使用雾化器，有些参与者与家中其他人共享。许多人报告说，他们更喜欢使用雾化器来缓解严重症状，避免急诊室就诊或住院。费用对雾化器使用的影响在参与者中有所不同。
尽管哮喘指南建议使用 MDI 而不是雾化器进行 SABA 给药，但在 PREPARE 研究参与者中，雾化器的使用很常见。临床医生应在评估哮喘控制时，探索患者使用雾化器的历史和经验。
