初级保健中患者使用干粉吸入器所犯严重吸入错误的特征及其与哮喘相关事件的联系
2016/06/20
摘要
目的：正确的吸入技术是哮喘治疗药物有效应用的核心。本研究的目的是确定与严重吸入技术错误相关的因素,以及在初级诊疗哮喘患者中使用干粉吸入器（DPI）准纳器时吸入技术错误的情况。
方法:这是一个使用iHARP数据库进行的回顾性的、多国的、横断面研究（2011-2013），包括来自八个国家的患者和医疗从业者的问卷调查，属国际性的。哮喘患者严重的吸入错误由iHARP督导委员会预先指定的训练有素的医疗从业者来观察。逐步减少的多因素Logistic回归分析，被用来确定临床特征以及与哮喘相关的一个以上的严重错误。
结果：3681哮喘患者中，623个（17%）使用准纳器（平均[SD]年龄，51 [ 14 ]；61%为女性）。共有341（55%）例患者犯了一个以上的严重错误。最常见的错误是在吸入前未吐气、吸入结束前吸气不足、从开始就吸气力不强。与≥1个严重错误显著相关的因素包括：前一年与哮喘相关的住院（比值比[OR] 2.07；95%可信区间[CI]，1.26-3.40），肥胖（OR 1.75；1.17-2.63），前4周哮喘控制差（或1.57；1.04-2.36），女性（或1.51；1.08-2.10），以及在过去一年没有回顾吸入技术（或1.45；1.04-2.02）。
结论：即使在使用设备错误率很低的时候，哮喘控制不佳的患者也应针对性的回顾他们的吸入技术。
（杨冬 审校）
J Asthma. 2016 Apr;53(3):321-9.doi:10.3109/02770903.2015.1099160.Epub 2016 Jan 26.
Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting.
Westerik JA1, Carter V2, Chrystyn H1,3, Burden A1, Thompson SL1, Ryan D4, Gruffydd-Jones K5, Haughney J6, Roche N7, Lavorini F8, Papi A9, Infantino A10,Roman-Rodriguez M11, Bosnic-Anticevich S12, Lisspers K13, Ställberg B13, Henrichsen SH14, van der Molen T15, Hutton C1, Price DB1,6.
Author information
Abstract
OBJECTIVE:Correct inhaler technique is central to effective delivery of asthma therapy. The study aim was to identify factors associated with serious inhaler technique errors and their prevalence among primary care patients with asthma using the Diskus dry powder inhaler (DPI).
METHODS:This was a historical, multinational, cross-sectional study (2011-2013) using the iHARP database, an international initiative that includes patient- and healthcare provider-reported questionnaires from eight countries. Patients with asthma were observed for serious inhaler errors by trained healthcare providers as predefined by the iHARP steering committee. Multivariable logistic regression, stepwise reduced, was used to identify clinical characteristics and asthma-related outcomes associated with ≥1 serious errors.
RESULTS:Of 3681 patients with asthma, 623 (17%) were using a Diskus (mean [SD] age, 51 [14]; 61% women). A total of 341 (55%) patients made ≥1 serious errors. The most common errors were the failure to exhale before inhalation, insufficient breath-hold at the end of inhalation, and inhalation that was not forceful from the start. Factors significantly associated with ≥1 serious errors included asthma-related hospitalization the previous year (odds ratio [OR] 2.07; 95% confidence interval [CI], 1.26-3.40); obesity (OR 1.75; 1.17-2.63); poor asthma control the previous 4 weeks (OR 1.57; 1.04-2.36); female sex (OR 1.51; 1.08-2.10); and no inhaler technique review during the previous year (OR 1.45; 1.04-2.02).
CONCLUSIONS:Patients with evidence of poor asthma control should be targeted for a review of their inhaler technique even when using a device thought to have a low error rate.
KEYWORDS:Asthma therapy; Diskus inhaler; cross-sectional; inhalation devices; multinational
J Asthma. 2016 Apr;53(3):321-9.doi:10.3109/02770903.2015.1099160.Epub 2016 Jan 26.
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婴儿期喉气管支气管异常以及与住院期间死亡的相关危险因素
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胃动力障碍与咳嗽变异型哮喘患者的咳嗽相关的生活质量的损害相关
