Rickenbach M A, Julious S A
University of Southampton.
Br J Gen Pract. 1994 Jul;44(384):317-8.
The importance of regular medication in order to control asthma symptoms is recognized. However, there is no accurate mechanism for assessing the fullness of aerosol inhalers. The contribution to asthma morbidity of unexpectedly running out of inhaled medication is unknown.
A study was undertaken to determine how patients assess inhaler fullness and the accuracy of their assessments, and to evaluate the floatation method of assessing inhaler fullness.
An interview survey of 98 patients (51% of those invited to take part), using 289 inhalers, was completed at one general practice in Hampshire.
One third of participants said they had difficulty assessing aerosol inhaler fullness and those aged 60 years and over were found to be more inaccurate in assessing fullness than younger participants. Shaking the inhaler to feel the contents move was the commonest method of assessment. When placed in water, an inhaler canister floating on its side with a corner of the canister valve exposed to air indicates that the canister is less than 15% full (sensitivity 90%, specificity 99%).
Floating a canister in water provides an objective measurement of aerosol inhaler fullness. Providing the method is recommended by the aerosol inhaler manufacturer, general practitioners should demonstrate the floatation method to patients experiencing difficulty in assessing inhaler fullness.
人们认识到规律用药对于控制哮喘症状的重要性。然而,目前尚无准确的机制来评估气雾剂吸入器的药物剩余量。吸入药物意外用完对哮喘发病率的影响尚不清楚。
开展一项研究,以确定患者如何评估吸入器的药物剩余量及其评估的准确性,并评估评估吸入器药物剩余量的漂浮法。
在汉普郡的一家普通诊所,对98名患者(占受邀参与人数的51%)进行了访谈调查,共使用了289个吸入器。
三分之一的参与者表示他们在评估气雾剂吸入器的药物剩余量时存在困难,且发现60岁及以上的参与者在评估药物剩余量时比年轻参与者更不准确。通过摇晃吸入器感受内部药物的移动是最常用的评估方法。将吸入器置于水中时,吸入器药罐一侧漂浮且药罐阀门一角暴露于空气中,表明药罐内药物剩余量不足15%(灵敏度90%,特异性99%)。
将药罐置于水中可客观测量气雾剂吸入器的药物剩余量。如果该方法得到气雾剂吸入器制造商的推荐,全科医生应为评估吸入器药物剩余量有困难的患者演示漂浮法。