吸入器设备选择如何以患者为中心?加拿大处方者调查。

Ingrid R Frank, Jamie Falk, C. Korownyk, M. Kolber, Aaron M Tejani
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摘要

背景吸入器类型的选择在哮喘和慢性阻塞性肺病(COPD)的治疗中起着至关重要的作用。由于吸入器种类繁多,选择和应用上的差异可能会给处方者和患者带来困惑。此外,不正确使用吸入器可能会导致治疗效果不理想或不充分。次要目标是评估这些因素的排序,包括确定哪些因素对处方者为患者选择吸入器装置的重要性和频率更高。方法于 2021 年末在门诊环境中开发并向加拿大西部的处方者(医生、执业护士和药剂师)分发了一份包含 10 个问题的在线调查问卷。要求处方者用自己的语言描述他们认为重要的因素,然后要求处方者针对两种情况(患有慢性阻塞性肺病的 83 岁女性和患有哮喘病的 21 岁男性)对所述因素的重要性进行排序。对结果进行了定性和定量研究。结果共有 82 位受访者完成了调查(2 种情景下共有 164 个回答)。总体而言,开药者的经验(84/164,51%)、成本(84/164,51%)、患者的易用性(59/164,36%)和患者的其他考虑因素(49/164,30%)是最常被提及的因素。情景 1(慢性阻塞性肺病)中最常提到的因素是处方者的经验,而情景 2(哮喘)中最常提到的因素是成本。结论在确定合适的吸入器类型时,受访者通常会优先考虑自己的经验以及成本和易用性。然而,许多受访者将处方医生的经验排在了所有其他因素之前。
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How Patient-Centred Are Inhaler Device Choices? A Survey of Canadian Prescribers.
Background The choice of inhaler device type can play a crucial role in managing asthma and chronic obstructive pulmonary disease (COPD). With various devices available, differences in choice and application may lead to confusion for both prescribers and patients. Furthermore, improper use of a device may lead to suboptimal or inadequate treatment. Objectives The primary objective was to identify factors that prescribers consider when selecting an inhaler device for a patient. The secondary objective was to evaluate the rankings of these factors, including identification of which factors had greater importance and frequency for prescribers' choice of inhaler device for patients. Methods A 10-question online survey was developed and distributed in late 2021 to prescribers (physicians, nurse practitioners, and pharmacists) in western Canada in an outpatient setting. Prescribers were asked to use their own words to describe the factors they considered important and were then asked to rank the stated factors in order of importance for 2 scenarios: an 83-year-old woman with COPD and a 21-year-old man with asthma. The results were examined qualitatively and quantitatively. Recurring themes were identified, and each response was categorized on the basis of its corresponding theme. Results In all, 82 respondents completed the survey (yielding a total of 164 responses across the 2 scenarios). Overall, prescriber experience (84/164, 51%), cost (84/164, 51%), patient ease of use (59/164, 36%), and other patient considerations (49/164, 30%) were the factors most frequently mentioned. The prescriber's experience was most often mentioned as a factor for scenario 1 (COPD), whereas cost was most often mentioned for scenario 2 (asthma). In both scenarios, prescriber experience was the highest-ranked factor. Conclusions When determining the appropriate type of inhaler device, respondents frequently prioritized their own experience, as well as cost and ease of use. However, many respondents ranked prescriber experience higher than all other factors.
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