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评估药师在指导成年哮喘患者正确使用吸入器技术方面的作用及其对哮喘控制、依从性和生活质量的影响。

Assessing the Pharmacist's Role in Counseling Asthmatic Adults Using the Correct Inhaler Technique and Its Effect on Asthma Control, Adherence, and Quality of Life.

作者信息

Al-Awaisheh Rawa'a Ibrahim, Alsayed Ahmad R, Basheti Iman A

机构信息

Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11937, Jordan.

School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

出版信息

Patient Prefer Adherence. 2023 Apr 6;17:961-972. doi: 10.2147/PPA.S395258. eCollection 2023.

Abstract

PURPOSE

This study was designed to assess inhaler technique skills, asthma control level, adherence, and quality of life scores amongst asthmatic patients living in Amman, Jordan, investigating the role of pharmacist's educational intervention.

PATIENTS AND METHODS

This single-blinded randomized parallel-group active-controlled study was conducted at the Jordan University Hospital (JUH) clinic in 2019. Patients were assessed at baseline and follow-up (after three months) on their inhaler technique (based on validated published checklists), asthma control based on the asthma control test (ACT) questionnaire, adherence to treatment, and quality of life (QoL). Patients in the active group were counseled on correct inhaler technique and administration skills, orally and using inhaler adhesive labels delivered by the clinical pharmacist.

RESULTS

Asthma patients (n = 157; active, n = 79, and control, n = 78) were recruited into the study and grouped based on the controller inhaler they were using (Turbohaler (TH) and Accuhaler (ACC). There was no statistically significant difference between both groups at baseline for inhaler technique, adherence, ACT, and QoL. At follow-up, 93.7% of the active group patients used their inhalers correctly, while only 16.7% of the control group used them correctly (P-value <0.001). Also, the ACT mean score was significantly higher for the active group (21.21±5.27) versus the control group (15.92±7.31; P-value <0.001). The QoL mean score was significantly improved for the active group compared with the control group (active = 63.85±24.78, Control = 38.746±3.23, P-value <0.001). Improvement in adherence for the active group was noticed compared with the control group but did not reach a significant level (P-value=0.691).

CONCLUSION

Through a practical educational intervention, pharmacists were found to significantly improve patients' asthma inhaler technique, ACT scores, and QoL scores for patients with asthma.

摘要

目的

本研究旨在评估约旦安曼哮喘患者的吸入器使用技巧、哮喘控制水平、依从性和生活质量得分,并调查药剂师教育干预的作用。

患者与方法

这项单盲随机平行组活性对照研究于2019年在约旦大学医院(JUH)诊所进行。在基线和随访时(三个月后)对患者的吸入器使用技巧(基于已发表的有效检查表)、基于哮喘控制测试(ACT)问卷的哮喘控制情况、治疗依从性和生活质量(QoL)进行评估。活性组的患者接受了关于正确吸入器使用技巧和给药技能的咨询,包括临床药剂师的口头指导以及使用吸入器粘贴标签。

结果

招募了哮喘患者(n = 157;活性组,n = 79,对照组,n = 78)进入研究,并根据他们使用的控制型吸入器(都保(TH)和准纳器(ACC))进行分组。两组在基线时的吸入器使用技巧、依从性、ACT和QoL方面无统计学显著差异。在随访时,活性组93.7%的患者正确使用了吸入器,而对照组只有16.7%的患者正确使用(P值<0.001)。此外,活性组的ACT平均得分(21.21±5.27)显著高于对照组(15.92±7.31;P值<0.001)。与对照组相比,活性组的QoL平均得分显著提高(活性组 = 63.85±24.78,对照组 = 38.746±3.23,P值<0.001)。与对照组相比,活性组的依从性有所改善,但未达到显著水平(P值 = 0.691)。

结论

通过实际的教育干预,发现药剂师可显著改善哮喘患者的哮喘吸入器使用技巧、ACT得分和QoL得分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42e6/10084832/dba6c77f52d1/PPA-17-961-g0001.jpg

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