使用不同类型吸入器的哮喘和慢性阻塞性肺疾病患者教育后与吸入技术相关的错误——系统评价和荟萃分析

Inhalation technique-related errors after education among asthma and COPD patients using different types of inhalers - systematic review and meta-analysis.

作者信息

Marko Monika, Pawliczak Rafał

机构信息

Department of Immunopathology, Faculty of Medicine, Division of Biomedical Science, Medical University of Lodz, Lodz, Poland.

出版信息

NPJ Prim Care Respir Med. 2025 Mar 18;35(1):15. doi: 10.1038/s41533-025-00422-0.

In asthma and chronic obstructive pulmonary disease (COPD) incorrect use of inhalers is still common. The aim of the study was to detect whether education improves inhalation skills and whether the type of education influenced the educational effect depending on the device. A systematic review and meta-analysis for errors during inhalation before and after education was performed. The selected data allowed for education assessment of dry powder (DPIs) and pressurised metered dose (pMDI/MDIs) inhalers in a meta-analysis. Education reduced critical errors (risk ratio [RR], 0.28, 95% confidence interval [CI]: 0.17, 0.47, P < 0.00001) and any incorrect use events for DPI (RR = 0.38, 95% CI: 0.21, 0.70, P = 0.002) and pMDI/MDIs, (RR = 0.16, 95% CI: 0.11, 0.23, P < 0.00001). Education improves patient's inhalation skills regardless of the device. The educational effect for pMDI/MDIs depends on the type of educational approach which has not been demonstrated for DPIs.

在哮喘和慢性阻塞性肺疾病（COPD）中，吸入器使用不当的情况仍然很常见。本研究的目的是检测教育是否能提高吸入技术，以及教育类型是否会根据设备不同而影响教育效果。我们对教育前后吸入过程中的错误进行了系统评价和荟萃分析。所选数据允许在荟萃分析中对干粉吸入器（DPI）和压力定量吸入器（pMDI/MDI）进行教育评估。教育减少了严重错误（风险比[RR]，0.28，95%置信区间[CI]：0.17，0.47，P < 0.00001）以及DPI（RR = 0.38，95% CI：0.21，0.70，P = 0.002）和pMDI/MDI的任何不当使用事件（RR = 0.16，95% CI：0.11，0.23，P < 0.00001）。无论使用何种设备，教育都能提高患者的吸入技术。pMDI/MDI的教育效果取决于教育方法的类型，而DPI尚未证实这一点。