哮喘联盟

   摘要
   背景：哮喘未控制仍是患者进入急诊室救治和住院的常见原因。哮喘吸入装置使用不正确是导致哮喘未控制和频繁急诊的最可能的主要原因之一。
   目的：评价急诊哮喘患者的吸入装置使用方法，同时调查患者特征、不正确使用吸入装置的相关因素、以及其与哮喘控制和急诊室救治的相关性。
   方法：对沙特阿拉伯两家主要教学医院中在9个月期间因支气管哮喘发作进入急诊室救治的所有患者进行横断面研究。收集人口数据和哮喘管理信息，并采用吸入装置使用方法检查表评估每例患者的吸入装置使用方法。
   结果：研究共纳入450例哮喘患者。其中176例（39.1%）为男性，平均年龄为42.3 ±16.7岁，哮喘平均持续时间为155.9 ± 127.1周。203例（45%）患者存在哮喘吸入装置使用不正确，且与不规律临床随访(p = 0.0001)、缺乏哮喘教育(p = 0.0009)、哮喘未控制（ACT评分<15）(p = 0.001)、3次或以上急诊室救治(p = 0.0497)以及哮喘持续时间<52周（p=0.005）有关。多元回归分析显示，缺乏哮喘教育(OR =1.65; 95% CI: 1.07, 2.54)或缺乏定期随访(OR =1.73; 95% CI: 1.08, 2.76)更易导致哮喘吸入装置使用不正确。
   结论：哮喘吸入装置使用不正确与哮喘控制不佳和更频繁的急诊室救治相关。针对急诊室救治的哮喘患者，本研究同时提出了多个可避免导致吸入装置使用不正确的风险因素。

（刘国梁 审校）
Allergy Asthma Clin Immunol. 2013 Mar 6;9(1):8. [Epub ahead of print]

 

Improper inhaler technique is associated with poor asthma control and frequent emergency department visits.

Al-Jahdali H, Ahmed A, Al-Harbi A, Khan M, Baharoon S, Bin Salih S, Halwani R, Al-Muhsen S.

Abstract
BACKGROUND:Uncontrolled asthma remains a frequent cause of emergency department (ED) visits and hospital admissions. Improper asthma inhaler device use is most likely one of the major causes associated with uncontrolled asthma and frequent ED visits.
OBJECTIVES：To evaluate the inhaler technique among asthmatic patients seen in ED, and to investigate the characteristics of these patients and factors associated with improper use of inhaler devices and its relationship with asthma control and ED visits.
METHODS:A cross-sectional study of all the patients who visited the ED with bronchial asthma attacks over a 9-month period was undertaken at two major academic hospitals in Saudi Arabia. Information was collected about demographic data and asthma management and we assessed the inhaler techniques for each patient using an inhaler technique checklist.
RESULTS:A total of 450 asthma patients were included in the study. Of these, 176(39.1%) were males with a mean age of 42.3 ±16.7 years and the mean duration of asthma was 155.9 ± 127.1 weeks. The improper use of asthma inhaler devices was observed in 203(45%) of the patients and was associated with irregular clinic follow-ups (p = 0.0001), lack of asthma education (p = 0.0009), uncontrolled asthma ACT (score ¿ 15) (p = 0.001), three or more ED visits (p = 0.0497), and duration of asthma of less than 52 weeks (p = 0.005). Multiple logistic regression analysis revealed that a lack of education about asthma disease (OR =1.65; 95% CI: 1.07, 2.54) or a lack of regular follow-up (OR =1.73; 95% CI: 1.08, 2.76) was more likely to lead to the improper use of an asthma inhaler device.
CONCLUSION:Improper asthma inhaler device use is associated with poor asthma control and more frequent ED visits. We also identified many avoidable risk factors leading to the improper use of inhaler devices among asthma patients visiting the ED。
 

Allergy Asthma Clin Immunol. 2013 Mar 6;9(1):8. [Epub ahead of print]