Bhattarai Aashish, Shakya Rajani, Bista Durga
Department of Pharmacy, School of Science, Kathmandu University, Dhulikhel, Nepal.
Patient Prefer Adherence. 2024 Jul 1;18:1395-1408. doi: 10.2147/PPA.S460810. eCollection 2024.
Asthma and Chronic obstructive pulmonary disease (COPD) are chronic respiratory conditions characterized by airflow obstruction and respiratory symptoms. Adherence to prescribed inhaler therapy and correct inhalation technique are essential for effective disease management and optimal disease control. However, non-adherence and incorrect inhalation technique are common challenges faced by patients with asthma and COPD, leading to suboptimal treatment outcomes and increased healthcare burden.
To study the impact of a pharmacist-led intervention on inhaler adherence, inhalation technique, and disease control among patients with asthma and COPD.
A pre-post interventional design assessed the effects of pharmacist-led intervention on inhaler adherence, inhalation techniques, and disease control in asthma and COPD patients at Dhulikhel Hospital in Nepal. Inclusion criteria: adult patient clinically diagnosed with asthma or COPD patients of all genders. The intervention comprised counseling patients with aids like videos, and informational leaflets. Impact was measured using checklist method for inhalation technique, the Test of Adherence to Inhaler (TAI) questionnaire for adherence to inhaler, and "Asthma Control Test (ACT)" or "COPD Assessment Test (CAT)" for disease control.
The pharmacist-led intervention significantly increased adherence to inhalers, evidenced by a notable rise in the proportion of patients with good adherence (<0.001). Sporadic, deliberate, and unwitting noncompliance pattern also improved significantly after the intervention (<0.001, <0.001 and =0.001). Inhalation technique exhibited substantial improvement after intervention (<0.001). The analysis indicated significant moderate negative correlations between "TIA" and "CAT" [=-0.31; P=0.01], and between "inhalation technique score" and "CAT score" [=-0.31; =0.01] suggesting that as adherence to inhaler usage and inhalation technique improve, CAT scores tend to decrease, indicating reduced disease impact on the patient.
This study shows the potential efficacy of pharmacist-led intervention in enhancing adherence to inhaler, inhalation technique, and disease control in respiratory conditions such as asthma and COPD.
哮喘和慢性阻塞性肺疾病（COPD）是慢性呼吸道疾病，其特征为气流受限和呼吸道症状。坚持使用规定的吸入器疗法并掌握正确的吸入技术对于有效管理疾病和实现最佳疾病控制至关重要。然而，不坚持治疗和不正确的吸入技术是哮喘和COPD患者面临的常见挑战，导致治疗效果欠佳并增加医疗负担。
研究由药剂师主导的干预措施对哮喘和COPD患者吸入器依从性、吸入技术和疾病控制的影响。
采用干预前后设计，评估在尼泊尔杜利凯尔医院由药剂师主导的干预措施对哮喘和COPD患者吸入器依从性、吸入技术和疾病控制的效果。纳入标准：临床诊断为哮喘或COPD的成年患者，不限性别。干预措施包括使用视频和信息传单等辅助手段为患者提供咨询。采用吸入技术检查表法测量影响，使用吸入器依从性测试（TAI）问卷评估吸入器依从性，使用“哮喘控制测试（ACT）”或“慢性阻塞性肺疾病评估测试（CAT）”评估疾病控制情况。
由药剂师主导的干预措施显著提高了吸入器的依从性，依从性良好的患者比例显著上升（<0.001）证明了这一点。干预后，偶发性、故意性和无意识的不依从模式也有显著改善（<0.001、<0.001和=0.001）。干预后吸入技术有显著改善（<0.001）。分析表明，“TIA”与“CAT”之间存在显著的中度负相关[=-0.31；P=0.01]，“吸入技术得分”与“CAT得分”之间也存在显著的中度负相关[=-0.31；=0.01]，这表明随着吸入器使用依从性和吸入技术的提高，CAT得分往往会降低，表明疾病对患者的影响减小。
本研究表明，由药剂师主导的干预措施在提高哮喘和COPD等呼吸道疾病患者对吸入器的依从性、吸入技术和疾病控制方面具有潜在疗效。
