van der Palen J, Klein J J, Kerkhoff A H
Medisch Spectrum Twente, afd. Longziekten, Enschede.
Ned Tijdschr Geneeskd. 1994 Jul 9;138(28):1417-22.
To describe errors in inhaler technique of patients with chronic obstructive pulmonary disease (COPD).
Outpatient clinic, Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.
Descriptive.
Adult COPD patients who already used an inhaler were asked to demonstrate their inhaler technique. Using a inhaler-specific checklist errors were registered. A division was made into good, adequate and inadequate technique. For each inhaler a selection of critical actions with regard to effective inhaler technique was made.
Inhaler technique was assessed in 123 COPD patients. Over one-third of all patients had a very poor inhaler technique, which probably resulted in little or even no drug deposition at all. 42% of the patients performed all essential inhaler actions correctly. For patients with a Diskhaler this was 86%, significantly higher than for the other inhalers, Rotahaler and Turbuhaler, which did not differ much (35% and 46%). Poor inhalation technique leads to insufficient bronchodilating or prophylactic effect, to the prescription of more or additional medication with a higher probability of side effects, and to increased costs.
The inhalation technique can be improved substantially with a good instruction protocol.
描述慢性阻塞性肺疾病（COPD）患者吸入器使用技术中的错误。
荷兰恩斯赫德的特温特医学光谱医院肺病科门诊。
描述性研究。
要求已使用吸入器的成年COPD患者演示其吸入器使用技术。使用特定于吸入器的检查表记录错误。将吸入器使用技术分为良好、 adequate和不足三类。针对每种吸入器，选择了与有效吸入器使用技术相关的关键操作。
对123例COPD患者的吸入器使用技术进行了评估。超过三分之一的患者吸入器使用技术非常差，这可能导致很少或几乎没有药物沉积。42%的患者正确执行了所有基本的吸入器操作。使用Diskhaler的患者中这一比例为86%，显著高于其他吸入器Rotahaler和Turbuhaler（分别为35%和46%），后两者差异不大。吸入技术不佳会导致支气管扩张或预防效果不足，增加开具副作用可能性更高的更多或额外药物的处方，并增加成本。
通过良好的指导方案可大幅改善吸入技术。
