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药剂师在慢性阻塞性肺疾病吸入器选择与教育中的作用

The Role of the Pharmacist in Inhaler Selection and Education in Chronic Obstructive Pulmonary Disease.

作者信息

Petite Sarah E, Hess Michael W, Wachtel Herbert

机构信息

The University of Toledo, Toledo, OH, USA.

WMed Health, Western Michigan University, Kalamazoo, MI, USA.

出版信息

J Pharm Technol. 2021 Apr;37(2):95-106. doi: 10.1177/8755122520937649. Epub 2020 Jul 8.

Abstract

To review the role of pharmacists in educating and monitoring patients with chronic obstructive pulmonary disease (COPD) on inhalation technique. A PubMed search (January 2000 to May 2020) was performed using the following keywords and associated medical subject headings: adherence, chronic obstructive pulmonary disease/COPD, education, inhaler, pharmacist, and technique. The search was conducted to identify English language articles highlighting the importance of correct inhaler technique in COPD management and benefits of pharmacist inhaler training such as improved adherence, quality of life (QoL), and disease control. Randomized controlled trials, retrospective studies, observational studies, systematic reviews, and meta-analysis reporting pharmacist training were included. This review summarizes that incorrect inhaler use negatively affects treatment outcomes, prognosis, and QoL. Pharmacists are in a unique position to educate and monitor patients with COPD on optimal inhaler technique and an individualized, multifactorial approach to COPD management involving pharmacists could provide cost-effective patient care and improve adherence and minimize inhaler misuse. Several strategies used by pharmacists can optimize patient inhaler use, such as face-to-face technique demonstrations, the "teach-back" method, telemonitoring, instructional videos, or informational leaflets. An individualized action plan involving education and regular monitoring of inhaler use further enhances optimal adherence and disease management. As pharmacists are easily accessible to both patients and health care providers, they are ideally placed to play an important role in the enhancement of education on, and continuous assessment of, optimal inhaler technique, thereby improving adherence, disease control, and QoL.

摘要

回顾药剂师在对慢性阻塞性肺疾病(COPD)患者进行吸入技术教育和监测方面的作用。使用以下关键词及相关医学主题词在PubMed数据库进行检索(2000年1月至2020年5月):依从性、慢性阻塞性肺疾病/COPD、教育、吸入器、药剂师和技术。检索旨在识别强调正确吸入器技术在COPD管理中的重要性以及药剂师进行吸入器培训的益处(如提高依从性、生活质量(QoL)和疾病控制)的英文文章。纳入报告药剂师培训的随机对照试验、回顾性研究、观察性研究、系统评价和荟萃分析。本综述总结出,吸入器使用不当会对治疗结果、预后和生活质量产生负面影响。药剂师处于独特地位,能够就最佳吸入器技术对COPD患者进行教育和监测,采用涉及药剂师的个体化、多因素COPD管理方法可提供具有成本效益的患者护理,提高依从性并减少吸入器误用。药剂师使用的几种策略可优化患者的吸入器使用,如面对面技术演示、“反馈”方法、远程监测、教学视频或信息传单。涉及教育和定期监测吸入器使用的个体化行动计划可进一步提高最佳依从性和疾病管理水平。由于患者和医疗服务提供者都很容易联系到药剂师,他们非常适合在加强最佳吸入器技术教育和持续评估方面发挥重要作用,从而提高依从性、疾病控制和生活质量。

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