Liang Lina, Huang Ruogang, Li Yun, Wang Zhufeng, Peng Kang, Lin Junfeng, Huang Feifei, Yao Xiaoyin, Zheng Jinping, Gao Yi
National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Guangzhou Nansha Maternity & Child Healthcare Hospital, Guangzhou, China.
BMC Pulm Med. 2025 Aug 8;25(1):381. doi: 10.1186/s12890-025-03834-3.
BACKGROUND: The Turbuhaler is a dry powder inhaler (DPI) that is commonly used in the treatment of asthmatic patients aged 5 years and above. Nevertheless, the technique of using the Turbuhaler in the real world remains ambiguous. This study aims to evaluate techniques in using Turbuhaler by combining a checklist with inhalation parameters and to investigate the association between the patient characteristics and inhaler technique. METHODS: This study recruited asthmatic children aged 4 to 14 years who were using the Turbuhaler from The First Affiliated Hospital of Guangzhou Medical University from August 2023 to August 2024. The technique of using Turbuhaler was evaluated step by step, and the inhalation parameters of patients were subsequently tested. Influencing factors related to inhaler technique were analyzed by ordered logistic regression analysis. RESULTS: Of the 141 enrolled patients, 50 (35.5%) scored 10 points on the checklist. Overall, 105 (74.4%), 28 (19.9%) and 8 (5.7%) patients performed good, moderate, and poor inhaler technique, respectively. The three common improper steps were ''exhale to residual volume'' (35.5%), "inhale forcefully and deeply" (13.5%), "rinse mouth after inhalation" (13.5%). The three common inappropriate inhalation parameters were "Effective inspiratory time(EIT) < 2s" (90.8%), "Peak inspiratory flow rate(PIFR) < 60L/min" (41.8%), and "Breath-hold time(BHT) < 5s" (27.0%). In the three groups with good, moderate, poor inhaler techniques, 0, 2 (7.1%), and 2 (25.0%) patients did not reach the minimum PIFR. Meanwhile, 38 (36.2%), 15 (53.6%), and 6 (75.0%) patients did not reach the optimal PIFR, respectively. The results of ordered logistic regression analysis indicated that low medication adherence (P = 0.045), PIFR (P = 0.041), BHT (P = 0.003) and the duration of Turbuhaler use (P = 0.009) were the primary factors influencing asthmatic children's inhaler technique. CONCLUSION: The improper use of inhalers and inappropriate inhalation parameters are common among asthmatic children. Using checklist and inhalation parameters enables a more comprehensive evaluation of the patients' inhalation maneuvers and inspiratory effort. TRIAL REGISTRATION: This study is registered at Chictr.org with the identifier number ChiCTR2200056579.
背景：都保是一种干粉吸入器（DPI），常用于治疗5岁及以上的哮喘患者。然而，在现实世界中使用都保的技术仍不明确。本研究旨在通过将检查表与吸入参数相结合来评估使用都保的技术，并调查患者特征与吸入器技术之间的关联。 方法：本研究招募了2023年8月至2024年8月期间在广州医科大学附属第一医院使用都保的4至14岁哮喘儿童。逐步评估使用都保的技术，随后测试患者的吸入参数。通过有序逻辑回归分析分析与吸入器技术相关的影响因素。 结果：在141名登记患者中，50名（35.5%）在检查表上得10分。总体而言，105名（74.4%）、28名（19.9%）和8名（5.7%）患者的吸入器技术分别为良好、中等和较差。三个常见的不当步骤是“呼气至残气量”（35.5%）、“用力深吸气”（13.5%）、“吸入后漱口”（13.5%）。三个常见的不当吸入参数是“有效吸气时间（EIT）<2秒”（90.8%）、“最大吸气流量（PIFR）<60升/分钟”（41.8%）和“屏气时间（BHT）<5秒”（27.0%）。在吸入器技术良好、中等、较差的三组中，分别有0名、2名（7.1%）和2名（25.0%）患者未达到最小PIFR。同时，分别有38名（36.2%）、15名（53.6%）和6名（75.0%）患者未达到最佳PIFR。有序逻辑回归分析结果表明，低药物依从性（P = 0.045）、PIFR（P = 0.041）、BHT（P = 0.003）和都保使用时长（P = 0.009）是影响哮喘儿童吸入器技术的主要因素。 结论：哮喘儿童中吸入器使用不当和吸入参数不合适很常见。使用检查表和吸入参数能够更全面地评估患者的吸入动作和吸气努力。 试验注册：本研究在Chictr.org注册，标识符为ChiCTR2200056579。
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