Petro W, Gebert P, Lauber B
Fachklinik für Erkrankungen der Atmungsorgane und Allergien, Klinik Bad Reichenhall.
Pneumologie. 1994 Mar;48(3):191-6.
Preparations administered by inhalation make relatively high demands on the skill and knowledge of the patient in handling this form of application, for the effectivity of the therapy is inseparably linked to its faultless application. The present article aims at analysing possible mistakes in handling and at finding the most effective way of avoiding them. Several groups of patients with different previous knowledge were analysed in respect of handling skill and the influence of training on an improvement of the same; the patients' self-assessment was analysed by questioning them. Most mistakes are committed by patients whose only information consists of the contents of the package circular. Written instructions alone cannot convey sufficient information especially on how to synchronize the release operations. Major mistakes are insufficient expiration before application in 85.6% of the patients and lack of synchronisation in 55.9%, while the lowest rate of errors in respect of handling was seen in patients who had undergone training and instruction. Training in application associated with demonstration and subsequent exercise reduces the error ratio to a tolerable level. Pulverizers free from propelling gas and preparations applied by means of a spacer are clearly superior to others in respect of a comparatively low error rate. 99.3% of all patients believe they are correctly following the instructions, but on going into the question more deeply it becomes apparent that 37.1% of them make incorrect statements. Hence, practical training in application should get top priority in the treatment of obstructive diseases of the airways. The individual steps of inhalation technique must be explained in detail and demonstrated by means of a placebo dosage aerosol.(ABSTRACT TRUNCATED AT 250 WORDS)
通过吸入给药的制剂对患者处理这种给药方式的技能和知识要求相对较高,因为治疗效果与正确应用密切相关。本文旨在分析使用过程中可能出现的错误,并找到最有效的避免方法。对几组具有不同既往知识的患者在使用技能以及培训对技能提高的影响方面进行了分析;通过询问患者来分析他们的自我评估。大多数错误是由那些仅从药品说明书中获取信息的患者犯下的。仅靠书面说明无法传达足够的信息,尤其是关于如何同步释放操作的信息。主要错误包括85.6%的患者在使用前呼气不足以及55.9%的患者缺乏同步性,而在接受过培训和指导的患者中,使用错误率最低。与示范和后续练习相关的使用培训可将错误率降低到可容忍的水平。在错误率相对较低方面,无推进气体的雾化器和通过储物罐给药的制剂明显优于其他产品。99.3%的患者认为他们正确遵循了说明,但深入研究这个问题后发现,其中37.1%的患者陈述有误。因此,在气道阻塞性疾病的治疗中,使用方面的实践培训应被置于首位。吸入技术的各个步骤必须详细解释,并通过安慰剂剂量气雾剂进行演示。(摘要截选至250字)