Choomuang Woranoot, Pothirat Chaicharn, Chaiwong Warawut, Liwsrisakun Chalerm, Theerakittikul Theerakorn, Phetsuk Nittaya, Chanayat Panida
Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Thorac Dis. 2022 Apr;14(4):919-926. doi: 10.21037/jtd-21-1612.
Pressurized metered-dose inhaler (pMDI) is the most commonly used inhaler devices in community hospitals in Thailand. However, the research work on large group demonstration training method in the use of pMDI and pMDI with spacer in cases of chronic obstructive pulmonary disease (COPD) is very limited. Therefore, this study aimed to evaluate the effectiveness of this training method in elderly with COPD patients.
This prospective cross-sectional study was conducted at COPD clinic, Chiang Dao Hospital, Chiang Mai, Thailand between June 2019 and July 2019. All patients being treated in the clinic were assessed for their inhalation technique and inspiratory flow. After the initial assessment, patients were given instructions regarding the correct inhalation technique of pMDI and pMDI with spacer devices through large group demonstration. One month later, inhalation techniques and inspiratory flow were re-assessed.
A total of 104 COPD patients were included, mean age 70.9±8.3 years, 51 (49.0%) male. At their first visit, 75.0% of pMDI and 81.7% of pMDI with spacer users performed at least one essential step incorrectly. After receiving large group demonstration training, there was a statistically significant increase in all devices; 26.7% 56.7%, P=0.001 for correct technique, 41.7% 62.7%, P=0.026 for appropriate flow, and 11.7% 36.7%, P=0.001 for correct technique and flow.
The provision of large group training significantly increases the correct use of inhalation techniques and inspiratory flow for pMDI and pMDI with spacer in elderly with COPD.
压力定量吸入器（pMDI）是泰国社区医院最常用的吸入装置。然而，关于慢性阻塞性肺疾病（COPD）患者使用pMDI及带储雾罐的pMDI的大组示范培训方法的研究工作非常有限。因此，本研究旨在评估该培训方法对老年COPD患者的有效性。
本前瞻性横断面研究于2019年6月至2019年7月在泰国清迈清道医院的COPD门诊进行。对门诊所有接受治疗的患者的吸入技术和吸气流量进行评估。初始评估后，通过大组示范向患者讲解pMDI及带储雾罐的pMDI的正确吸入技术。1个月后，再次评估吸入技术和吸气流量。
共纳入104例COPD患者，平均年龄70.9±8.3岁，男性51例（49.0%）。初诊时，75.0%使用pMDI的患者和81.7%使用带储雾罐pMDI的患者至少有一个关键步骤操作错误。接受大组示范培训后，所有装置在正确技术方面均有统计学显著提高；从26.7%提高到56.7%，P = 0.001；在合适流量方面，从41.7%提高到62.7%，P = 0.026；在正确技术和流量方面，从11.7%提高到36.7%，P = 0.001。
提供大组培训显著提高了老年COPD患者正确使用pMDI及带储雾罐pMDI的吸入技术和吸气流量。
