Davison John, Robinson-Barella Anna, Davies Gareth, Campos-Hinojosa Marina, Collins Camille, Husband Andy, Okeowo Daniel, Hester Katy L M, Lee Richard, Rapley Tim, De Soyza Anthony
Adult Bronchiectasis Service Freeman Hospital, Newcastle upon Tyne, UK.
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
ERJ Open Res. 2023 May 30;9(3). doi: 10.1183/23120541.00735-2022. eCollection 2023 May.
Regular daily nebulised antibiotics are widely used in managing bronchiectasis. This patient population typically has severe bronchiectasis requiring multiple other medications. Given that little is known about patients' views and preferences for such therapies, this was the focus of our study.
To explore patient lived-experience using nebulised antibiotics, focus groups and semi-structured interviews were conducted with patients and carers; these were audio-recorded and transcribed to enable thematic analysis. QSR NVivo software facilitated data management. The themes developed from the qualitative data analysis were then used to co-design a questionnaire to capture attitudes and preferences towards nebulised therapy. Questionnaires were completed by patients and statistical analysis was performed. Ethical approval was obtained (13/WS/0036).
The study's focus groups comprised 13 patients and carers, and 101 patients completed the questionnaire. Patients described nebulised therapy as an imposition on their daily routine, in turn affecting reported rates of adherence. Results demonstrated that 10% of all patients using nebulised antibiotics found these hard/very hard to administer. Further, 53% of participants strongly agreed/agreed that they would prefer an antibiotic delivered by an inhaler over a nebuliser, if it were as effective at preventing exacerbations. Notably, only 10% of participants wished to remain on nebulised therapy.
Inhaled antibiotics delivered dry powder devices were deemed quicker and easier to use by patients. Providing they were at least as effective as current nebulised treatments, patients deemed inhaled antibiotics to be a preferable treatment option.
每日规律使用雾化抗生素在支气管扩张症的治疗中被广泛应用。这类患者群体通常患有严重的支气管扩张症，需要使用多种其他药物。鉴于对患者对于此类治疗方法的观点和偏好了解甚少，这成为了我们研究的重点。
为探究患者使用雾化抗生素的实际体验，我们对患者及其护理人员进行了焦点小组讨论和半结构化访谈；这些访谈进行了录音并转录，以便进行主题分析。QSR NVivo软件辅助进行数据管理。然后，根据定性数据分析得出的主题共同设计了一份问卷，以了解患者对雾化治疗的态度和偏好。患者完成了问卷并进行了统计分析。研究获得了伦理批准（13/WS/0036）。
该研究的焦点小组由13名患者及其护理人员组成，101名患者完成了问卷。患者将雾化治疗描述为对其日常生活的一种负担，进而影响了报告的依从率。结果显示，所有使用雾化抗生素的患者中有10%认为这些药物难以/非常难以使用。此外，53%的参与者强烈同意/同意，如果吸入式抗生素在预防病情加重方面同样有效，他们更愿意选择吸入式抗生素而非雾化器给药。值得注意的是，只有10%的参与者希望继续接受雾化治疗。
患者认为通过干粉装置给药的吸入式抗生素使用起来更快且更方便。只要它们至少与目前的雾化治疗效果相同，患者就认为吸入式抗生素是更可取的治疗选择。
