认识和解决哮喘和慢性阻塞性肺病临床实践中吸入器技术的衰退
2023/05/25
摘要
糟糕的吸入器技术仍然是哮喘和慢性阻塞性肺病（COPD）有效治疗的主要障碍。即使坚持处方的吸入维持治疗方案，也可能导致治疗效果不佳，从而可能导致治疗的不必要改变或升级。许多患者没有在线下接受过吸入器吸入技术的培训，即使在最初处方吸入药物的地方，此外也很少保持持续的评估和教育。在这篇综述中，我们概述了吸入器技术在培训后随着时间的推移而生疏的证据，调查了导致这种技术生疏的因素，并探索了解决这一问题的创新方法。我们还从文献和临床经验中提出了改进的步骤。
Recognizing and tackling inhaler technique decay in asthma and COPD clinical practice
Sinthia Bosnic-Anticevich, Bruce Bender, Melinda Shuler, Mike Hess, Janwillem Kocks
Abstract
Poor inhaler technique continues to represent a substantial barrier to effective asthma and chronic obstructive pulmonary disease (COPD) management. It can result in perceived lack of treatment effectiveness even with apparent adherence to a prescribed regimen of inhaled maintenance therapies, potentially resulting in unnecessary change or escalation of treatment. Many patients are not trained to inhaler mastery in real-world practice; furthermore, even where mastery is initially achieved, ongoing assessment and education are seldom maintained. In this review, we present an overview of the evidence for deterioration of inhaler technique over time following training, investigate the factors that contribute to this deterioration, and explore innovative approaches to addressing the problem. We also propose steps forward drawn from the literature and our clinical insights.
糟糕的吸入器技术仍然是哮喘和慢性阻塞性肺病（COPD）有效治疗的主要障碍。即使坚持处方的吸入维持治疗方案，也可能导致治疗效果不佳，从而可能导致治疗的不必要改变或升级。许多患者没有在线下接受过吸入器吸入技术的培训，即使在最初处方吸入药物的地方，此外也很少保持持续的评估和教育。在这篇综述中，我们概述了吸入器技术在培训后随着时间的推移而生疏的证据，调查了导致这种技术生疏的因素，并探索了解决这一问题的创新方法。我们还从文献和临床经验中提出了改进的步骤。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2023 May 3;S2213-2198(23)00472-5. doi: 10.1016/j.jaip.2023.04.031.)
(J Allergy Clin Immunol Pract. 2023 May 3;S2213-2198(23)00472-5. doi: 10.1016/j.jaip.2023.04.031.)
Recognizing and tackling inhaler technique decay in asthma and COPD clinical practice
Sinthia Bosnic-Anticevich, Bruce Bender, Melinda Shuler, Mike Hess, Janwillem Kocks
Abstract
Poor inhaler technique continues to represent a substantial barrier to effective asthma and chronic obstructive pulmonary disease (COPD) management. It can result in perceived lack of treatment effectiveness even with apparent adherence to a prescribed regimen of inhaled maintenance therapies, potentially resulting in unnecessary change or escalation of treatment. Many patients are not trained to inhaler mastery in real-world practice; furthermore, even where mastery is initially achieved, ongoing assessment and education are seldom maintained. In this review, we present an overview of the evidence for deterioration of inhaler technique over time following training, investigate the factors that contribute to this deterioration, and explore innovative approaches to addressing the problem. We also propose steps forward drawn from the literature and our clinical insights.
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开发和验证新的哮喘问卷，以帮助学龄儿童和青少年达到高水平的控制
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社会风险干预和小儿哮喘的卫生服务利用: 系统评价和荟萃分析
