Borris Joshua, Cook Heather, Chae Sulgi, Walker Kathryn A, McPherson Mary Lynn
Department of Practice, Sciences, and Heath Outcomes Research, School of Pharmacy, University of Maryland, Baltimore, MD 21201, USA.
MedStar Franklin Square Medical Center, Baltimore, MD 21237, USA.
Pharmacy (Basel). 2023 Jul 6;11(4):113. doi: 10.3390/pharmacy11040113.
Dry powder inhalers are an effective yet costly COPD medication-delivery device. Patients must possess a minimum peak inspiratory flow rate (PIFR) for inhaled medication to be properly deposited into the lungs. Hospitalized palliative-care patients with diminished lung function due to advanced COPD may not possess the minimum PIFR (30 L/min) for adequate drug delivery. This study aims to quantify PIFR values for hospitalized palliative-care patients with advanced COPD to evaluate whether these patients meet the minimum PIFR requirements. Hospitalized patients ≥18 years old with a palliative-care consultation were eligible if they had a diagnosis of advanced COPD (GOLD C or D). Patients were excluded if they lacked decision-making capacity or had a positive COVID-19 test within the previous 90 days. Three PIFR values were recorded utilizing the In-Check device, with the highest of the three PIFR attempts being utilized for statistical analysis. Eighteen patients were enrolled, and the mean of the highest PIFR readings was 72.5 L/min (±29 L/min). Post hoc analysis indicated 99.9% power when comparing the average best PIFR to the minimum PIFR (30 L/min) but only 51.4% power when compared to the optimal PIFR (60 L/min). This study found that palliative-care patients possess the minimum PIFR for DPI drug delivery.
干粉吸入器是一种有效的慢性阻塞性肺疾病(COPD)药物输送装置,但成本较高。患者必须具备最低的吸气峰流速(PIFR),吸入药物才能正确沉积到肺部。因晚期COPD导致肺功能下降的住院姑息治疗患者可能不具备足够药物输送所需的最低PIFR(30升/分钟)。本研究旨在量化晚期COPD住院姑息治疗患者的PIFR值,以评估这些患者是否满足最低PIFR要求。年龄≥18岁且接受姑息治疗咨询的住院患者,若诊断为晚期COPD(GOLD C或D级)则符合入选条件。若患者缺乏决策能力或在过去90天内COVID-19检测呈阳性,则被排除。使用In-Check设备记录三个PIFR值,将三次PIFR尝试中的最高值用于统计分析。共纳入18名患者,最高PIFR读数的平均值为72.5升/分钟(±29升/分钟)。事后分析表明,将平均最佳PIFR与最低PIFR(30升/分钟)进行比较时检验效能为99.9%,但与最佳PIFR(60升/分钟)进行比较时检验效能仅为51.4%。本研究发现,姑息治疗患者具备干粉吸入器药物输送所需的最低PIFR。
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