伦敦哮喘和慢性阻塞性肺疾病患者依从性及吸入器技术的客观评估:一项在社区药房使用电子监测设备的研究
Objective Assessment of Adherence and Inhaler Technique among Asthma and COPD Patients in London: A Study in Community Pharmacies Using an Electronic Monitoring Device.
作者信息
Hesso Iman, Nabhani-Gebara Shereen, Kayyali Reem
机构信息
School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Penrhyn Road, Kingston upon Thames, London KT1 2EE, UK.
出版信息
Pharmacy (Basel). 2023 Jun 4;11(3):94. doi: 10.3390/pharmacy11030094.
BACKGROUND
The INhaler Compliance Assessment (INCA) device is an electronic monitoring device (EMD) that assesses both patient's adherence and inhaler technique (IT). This study aimed, first, to assess the value of using the INCA device as an objective measure during medicine use review (MUR) consultations provided by community pharmacists (CPs) on patients' adherence and IT. Second, we aimed to explore patients' perceptions about the INCA device.
METHODS
A mixed methods approach was used, involving two phases. Phase one was a service evaluation in independent community pharmacies in London with a before-and-after study design. The service included provision of an MUR consultation to asthma and COPD patients using objective feedback about adherence and IT generated with the INCA device. Descriptive and inferential statistics were performed using SPSS. Phase two involved semi-structured interviews with respiratory patients. Thematic analysis was performed to generate key findings.
MAIN FINDINGS
Eighteen patients participated in the study (12 COPD and 6 asthma). The results showed significant improvement in the INCA actual adherence from 30% to 68% ( = 0.001) and significant reduction in IT error rate from 51% to 12% ( = 0.002) after conducting the service. Analysis of the interviews revealed patients' positive attitudes in terms of the perceived benefits of the technology and a desire for future use and recommendation for others. Patients had also positive attitudes towards the consultations provided.
CONCLUSION
Embedding an objective measure about adherence and IT during CPs' consultations showed a significant improvement in patients' adherence and IT and was accepted by patients as well.
背景
吸入器依从性评估(INCA)设备是一种电子监测设备(EMD),可评估患者的依从性和吸入技术(IT)。本研究的目的,首先是评估在社区药剂师(CPs)为患者提供的用药回顾(MUR)咨询期间,使用INCA设备作为客观测量方法对患者依从性和吸入技术的价值。其次,我们旨在探索患者对INCA设备的看法。
方法
采用混合方法,包括两个阶段。第一阶段是在伦敦独立社区药房进行的服务评估,采用前后对照研究设计。该服务包括为哮喘和慢性阻塞性肺疾病(COPD)患者提供MUR咨询,并使用INCA设备生成的关于依从性和吸入技术的客观反馈。使用SPSS进行描述性和推断性统计。第二阶段涉及对呼吸疾病患者进行半结构化访谈。进行主题分析以得出关键发现。
主要发现
18名患者参与了该研究(12名COPD患者和6名哮喘患者)。结果显示,在提供该服务后,INCA实际依从性从30%显著提高到68%(P = 0.001),吸入技术错误率从51%显著降低到12%(P = 0.002)。对访谈的分析显示,患者对该技术的感知益处持积极态度,并希望未来使用并向他人推荐。患者对提供的咨询也持积极态度。
结论
在社区药剂师的咨询过程中纳入关于依从性和吸入技术的客观测量方法,显示出患者的依从性和吸入技术有显著改善,并且也为患者所接受。
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