哮喘和慢性阻塞性肺病患者吸入药物的使用和吸入技术:随机对照试验
2019/02/19
摘要
背景：哮喘和慢性阻塞性肺病患者的负担很高，患者经常因病情加重而住院。有很多原因导致哮喘和COPD患者控制水平不佳。这与患者不按照卫生保健指南、吸入技术不良和/或不按医嘱治疗有关。本研究旨在通过一项关于药物依从性的随机对照试验研究患者吸入技术对慢性肺部疾病患者生活质量(QoL)和症状控制的影响。
方法：对165例哮喘和COPD患者进行横断面分析。根据每种吸入装置的产品检查表测试患者吸入方法是否正确。采用COPD评估试验(CAT)和哮喘控制试验(ACT)对患者的生活质量和症状控制进行评估。测定一秒钟用力肺活量(FVC)和用力呼气量(FEV1)。
结果：总的来说，不正确的吸入技术范围从0到53%取决于吸入器的类型。COPD患者吸入装置使用方法正确比不正确者CAT总评分更高(P =0 .02)。此外，吸入装置使用方法不正确的COPD患者更容易咳嗽(P =0 .03)，并且在上坡或爬楼梯时更容易气短(P =0 .02)。与使用吸入设备方法不正确的COPD患者相比，正确使用吸入设备的COPD患者基线预测的平均FEV1%明显更好(P =0 .04) ，这在哮喘患者中没有发现显著性差异，。
结论：正确吸入处方药物与改善健康状况和肺功能有关。研究结果鼓励卫生专业人员为患者提供正确的吸入方法的指导，并定期重新评估患者的吸入技术。
Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial.
Gregoriano C, Dieterle T, Breitenstein AL, Dürr S, Baum A, Maier S, Arnet I, Hersberger KE, Leuppi JD.
Abstract
BACKGROUND: The burden of asthma and COPD among patients is high and people affected are frequently hospitalized due to exacerbations. There are numerous reasons for the lack of disease control in asthma and COPD patients. It is associated with non-adherence to guidelines on the part of the health care provider and with poor inhalation technique and/or non-adherence to the prescribed treatment plan by the patient. This study aims to present data on inhaler technique and its impact on quality of life (QoL) and symptom control in a typical population of patients with chronic lung disease from a randomized controlled trial on medication adherence.
METHODS: For this cross-sectional analysis, 165 asthma and COPD patients were analyzed. Correct application of inhaler devices was tested using pre-defined checklists for each inhaler type. QoL and symptom control were investigated using COPD Assessment Test (CAT) and Asthma Control Test (ACT). Spirometry was used to measure forced vital capacity (FVC) and forced expiratory volume in one second (FEV1).
RESULTS: Overall, incorrect inhalation technique ranged from 0 to 53% depending on the type of inhaler. COPD patients with incorrect device application had a higher CAT sum score compared to those with a correct device application (P = .02). Moreover, COPD patients with incorrect device application were more likely to suffer from cough (P = .03) and were more breathless while walking uphill or a flight of stairs (P = .02). While there was no significance found in asthma patients, COPD patients who used their devices correctly had a significantly better mean FEV1% predicted at baseline compared to those who applied their devices incorrectly (P = .04).
CONCLUSIONS: Correct inhalation of prescribed medication is associated with improved health status and lung function. These findings should encourage health professionals to provide instructions on correct inhalation technique and to regularly re-evaluate the patients' inhalation techniqu
背景：哮喘和慢性阻塞性肺病患者的负担很高，患者经常因病情加重而住院。有很多原因导致哮喘和COPD患者控制水平不佳。这与患者不按照卫生保健指南、吸入技术不良和/或不按医嘱治疗有关。本研究旨在通过一项关于药物依从性的随机对照试验研究患者吸入技术对慢性肺部疾病患者生活质量(QoL)和症状控制的影响。
方法：对165例哮喘和COPD患者进行横断面分析。根据每种吸入装置的产品检查表测试患者吸入方法是否正确。采用COPD评估试验(CAT)和哮喘控制试验(ACT)对患者的生活质量和症状控制进行评估。测定一秒钟用力肺活量(FVC)和用力呼气量(FEV1)。
结果：总的来说，不正确的吸入技术范围从0到53%取决于吸入器的类型。COPD患者吸入装置使用方法正确比不正确者CAT总评分更高(P =0 .02)。此外，吸入装置使用方法不正确的COPD患者更容易咳嗽(P =0 .03)，并且在上坡或爬楼梯时更容易气短(P =0 .02)。与使用吸入设备方法不正确的COPD患者相比，正确使用吸入设备的COPD患者基线预测的平均FEV1%明显更好(P =0 .04) ，这在哮喘患者中没有发现显著性差异，。
结论：正确吸入处方药物与改善健康状况和肺功能有关。研究结果鼓励卫生专业人员为患者提供正确的吸入方法的指导，并定期重新评估患者的吸入技术。
(中日友好医院呼吸与危重症医学科 禹汶伯 摘译 林江涛 审校)
(Respir Res. 2018 Dec 3;19(1):237. doi: 10.1186/s12931-018-0936-3.)
(Respir Res. 2018 Dec 3;19(1):237. doi: 10.1186/s12931-018-0936-3.)
Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial.
Gregoriano C, Dieterle T, Breitenstein AL, Dürr S, Baum A, Maier S, Arnet I, Hersberger KE, Leuppi JD.
Abstract
BACKGROUND: The burden of asthma and COPD among patients is high and people affected are frequently hospitalized due to exacerbations. There are numerous reasons for the lack of disease control in asthma and COPD patients. It is associated with non-adherence to guidelines on the part of the health care provider and with poor inhalation technique and/or non-adherence to the prescribed treatment plan by the patient. This study aims to present data on inhaler technique and its impact on quality of life (QoL) and symptom control in a typical population of patients with chronic lung disease from a randomized controlled trial on medication adherence.
METHODS: For this cross-sectional analysis, 165 asthma and COPD patients were analyzed. Correct application of inhaler devices was tested using pre-defined checklists for each inhaler type. QoL and symptom control were investigated using COPD Assessment Test (CAT) and Asthma Control Test (ACT). Spirometry was used to measure forced vital capacity (FVC) and forced expiratory volume in one second (FEV1).
RESULTS: Overall, incorrect inhalation technique ranged from 0 to 53% depending on the type of inhaler. COPD patients with incorrect device application had a higher CAT sum score compared to those with a correct device application (P = .02). Moreover, COPD patients with incorrect device application were more likely to suffer from cough (P = .03) and were more breathless while walking uphill or a flight of stairs (P = .02). While there was no significance found in asthma patients, COPD patients who used their devices correctly had a significantly better mean FEV1% predicted at baseline compared to those who applied their devices incorrectly (P = .04).
CONCLUSIONS: Correct inhalation of prescribed medication is associated with improved health status and lung function. These findings should encourage health professionals to provide instructions on correct inhalation technique and to regularly re-evaluate the patients' inhalation techniqu
上一篇：
过敏和哮喘疾病发展中的环境暴露的作用及其机制
下一篇：
全科医生数据采集和空间分析在理解COPD和哮喘方面的实用价值
