Press Valerie G.
Department of Medicine, University of Chicago, Chicago, Illinois, United States
Chronic Obstr Pulm Dis. 2024 Jul 25;11(4):331-340. doi: 10.15326/jcopdf.2024.0546.
Patients with chronic obstructive pulmonary disease (COPD) rely primarily on inhaled medications to control and treat symptoms. Although the medications delivered by inhaler devices are often quite efficacious when delivered to the lung, the real-world effectiveness of these inhaler devices often falls short. Barriers to effective inhaler use include inhaler misuse and cost-related nonadherence. Inhaler misuse can be reduced with appropriate education which leads to improved outcomes. Education can be provided in multiple settings by a wide array of clinicians and clinical team members including pharmacists, respiratory therapists, nurses, physicians, advanced practice nurses, physician assistants, and community health workers, among others. However, despite decades of research and existing effective strategies across settings and types of educators, overall not much progress has been made with respect to effective inhaler technique among populations of patients with COPD in nearly half a century. Similarly, cost-related nonadherence is a long-standing and critical barrier to effective control of COPD, with limited improvements, especially until very recently. This perspective reviews the current promising directions for inhaler-based therapies, ongoing challenges, and critical issues requiring urgent attention.
慢性阻塞性肺疾病（COPD）患者主要依靠吸入药物来控制和治疗症状。尽管吸入装置输送的药物在输送到肺部时通常相当有效，但这些吸入装置在现实世界中的有效性往往不足。有效使用吸入器的障碍包括吸入器使用不当和与费用相关的不依从性。通过适当的教育可以减少吸入器使用不当的情况，从而改善治疗效果。包括药剂师、呼吸治疗师、护士、医生、高级执业护士、医师助理和社区卫生工作者等在内的众多临床医生和临床团队成员可以在多种环境中提供教育。然而，尽管经过了数十年的研究，并且在不同环境和教育者类型中存在现有的有效策略，但在近半个世纪里，COPD患者群体在有效吸入技术方面总体进展甚微。同样，与费用相关的不依从性是有效控制COPD的一个长期且关键的障碍，改善有限，尤其是直到最近。本观点综述了基于吸入器疗法当前有前景的方向、持续存在的挑战以及需要紧急关注的关键问题。
