哮喘联盟

   摘要
   目的：本研究旨在评估三级医院哮喘专科门诊中吸入器使用技术对哮喘控制不佳患者基线和随访时的症状控制情况的影响。以及哮喘对患者生活质量的影响。
   方法：该为期6个多月的前瞻性研究纳入了来自科克大学医院新确诊的哮喘门诊患者。肺部护理专家使用有效的评分系统来评估患者的吸入器使用技术。分数未达标的患者接受吸入器使用方法的指导。患者完成有效的哮喘控制问卷(ACQ)和哮喘生存质量评估表(AQLQ)。在随访3～4个月后，再次评估吸入器使用技术以及再次完成哮喘控制问卷(ACQ)。
   结果：共纳入46例患者(女性=74%)，并对其中40例患者(40/46)进行了随访。基线平均[SD] FEV1 %预测值为76.5%[21.5]。在初步评估时63%的患者使用吸入器不正确。随访时减少至20%，表明培训后全体对于吸入器的使用有了显著的改善(p=0.003)。ACQ分数有显著提高，中位[四分位差] 从2.70[1.66]到2.00[1.90]，(p=0.002)。，基线评估结果表明哮喘对患者生活质量的影响程度为中度，中位AQLQ评分为4.75[1.97]。
   结论：患者教育以及正式评估吸入器使用技术，是哮喘临床评估中的重要组成部分。
 

（林江涛 审校）
J Asthma. 2014 Jan 6. [Epub ahead of print]

 

A Study to Assess Inhaler Technique and its potential impact on Asthma Control in Patients attending an Asthma Clinic.

Harnett C, Hunt E, Bowen B, O'Connell O, Edgeworth D, Mitchell P, Eustace J, Henry M, Kennedy M, Plant B, Murphy D.
 

ABSTRACT
OBJECTIVES: The aim of this study was to evaluate inhaler technique and symptom control in patients with poorly controlled asthma at baseline and at follow-up in a dedicated asthma clinic in a tertiary hospital. We also investigated the impact of asthma on these patients' quality of life.
METHODS: Patients referred to a newly established asthma clinic in Cork University Hospital were prospectively recruited over a 6 month period. Their inhaler technique was assessed by a pulmonary nurse specialist using a validated scoring system. They received instruction on inhaler usage when scores were suboptimal. Patients completed a validated asthma control questionnaire (ACQ) and asthma quality of life questionnaire (AQLQ). At follow-up 3-4 months later, inhaler technique was reassessed and the ACQ questionnaire repeated.
RESULTS: 46 patients were recruited (female=74%), and 40/46 were followed up. Mean[SD] FEV1 % predicted at baseline = 76.5%[21.5]. 63% of patients were classified as incorrectly using their inhaler at their initial assessment. This decreased to 20% at follow up, indicating an overall significant improvement in inhaler usage post-training (p=0.003). ACQ scores improved significantly from median[interquartile range] 2.70[1.66] to 2.00[1.90], (p=0.002). Baseline measurement indicated that patients' quality of life was moderately affected by asthma, with a median AQLQ score of 4.75 [1.97]
CONCLUSION:This study demonstrates the importance of educating and formally assessing inhaler technique in patients with asthma as part of their ongoing clinical review.
 

J Asthma. 2014 Jan 6. [Epub ahead of print]