Cvetkovski Biljana, Hespe Charlotte, House Rachel, Kritikos Vicky, Azzi Elizabeth, Evans Jack, Srour-Alphonse Pamela, Bosnic-Anticevich Sinthia
Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
School of Medicine, The University of Notre Dame Australia, Sydney, Australia.
Pulm Ther. 2022 Sep;8(3):283-296. doi: 10.1007/s41030-022-00197-6. Epub 2022 Jul 30.
Correct inhaler technique is essential for the optimal delivery of inhaled medicines and the successfully management of respiratory conditions. The general practitioner (GP), the prescriber of inhaled medicines, plays a crucial role in educating patients on inhaler technique. However, in the real-world setting, there are barriers. For the GP, it is time and competence and for the patient, it is their ability to recognise inhaler technique as an issue and their ability to maintain correct inhaler technique over time. This study aimed to determine GPs' experience, skills and priority placed on inhaler technique and to identify factor(s) associated with inhaler technique competence.
This cross-sectional observational study design surveyed GPs' perspectives on inhaler use and preferences for inhaler prescribing within their practice setting. GP inhaler technique was assessed. GPs were recruited through an established network of GP practices. Data collected include (i) practice demographics, (ii) inhaler technique opinions and experience, (iii) inhaler prescribing preferences and (iv) inhaler education history data. Data were analysed descriptively and multivariate logistic regression modelling was used to explore the relationship between outcomes and GPs' ability to use devices correctly.
A total of 227 GPs completed the inhaler survey. Sixty-three percent of GPs reported receiving previous inhaler education and 73.3% educated or checked their patients' inhaler technique; 64.5% felt they were somewhat competent in doing so. GPs who reported not demonstrating inhaler technique believed that a pharmacist or a practice nurse would do so. When prescribing new inhaler devices, GPs considered the disease being treated first and then patient's experience with inhalers; they often already have an inhaler preference and this was related to familiarity and perceived ease of use. For GPs, inhaler competence was not associated with their previous inhaler education or the priority placed on inhaler technique.
GPs do recognise the importance of inhaler technique in respiratory management but their technique can be better supported with regular educational updates to inform them about new inhalers and management practices and to support appropriate inhaler choices for their patients.
正确的吸入器使用技术对于吸入药物的最佳递送以及呼吸系统疾病的成功管理至关重要。全科医生(GP)作为吸入药物的开处方者,在指导患者掌握吸入器使用技术方面起着关键作用。然而,在现实环境中存在一些障碍。对于全科医生来说,存在时间和能力方面的问题;对于患者而言,则是他们认识到吸入器使用技术是一个问题的能力以及长期保持正确吸入器使用技术的能力。本研究旨在确定全科医生在吸入器使用技术方面的经验、技能和优先级,并识别与吸入器使用技术能力相关的因素。
本横断面观察性研究设计调查了全科医生在其执业环境中对吸入器使用的看法以及吸入器处方偏好。评估了全科医生的吸入器使用技术。通过一个既定的全科医生诊所网络招募全科医生。收集的数据包括:(i)诊所人口统计学信息,(ii)吸入器使用技术的意见和经验,(iii)吸入器处方偏好,以及(iv)吸入器教育历史数据。对数据进行描述性分析,并使用多变量逻辑回归模型来探讨结果与全科医生正确使用设备能力之间的关系。
共有227名全科医生完成了吸入器调查。63%的全科医生报告曾接受过吸入器相关教育,73.3%的医生对患者的吸入器使用技术进行过指导或检查;64.5%的医生认为自己在这方面有一定能力。报告未展示吸入器使用技术的全科医生认为药剂师或执业护士会这样做。在开具新的吸入器设备处方时,全科医生首先考虑所治疗的疾病,然后是患者使用吸入器的经验;他们通常已经有了吸入器偏好,这与熟悉程度和感知到的易用性有关。对于全科医生来说,吸入器使用能力与他们之前接受的吸入器教育或对吸入器使用技术的重视程度无关。
全科医生确实认识到吸入器使用技术在呼吸管理中的重要性,但通过定期的教育更新来更好地支持他们,告知他们有关新的吸入器和管理实践,并为他们的患者支持合适吸入器的选择,他们的技术会得到提升。