评估印度阻塞性气道疾病患者坚持吸入疗法和吸入技术关键错误对临床疗效的影响

Ajay Godse, Rakesh Gurjar, Namrata Rao, Shivanjali Gore, Ria Vijay
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摘要

吸入疗法的依从性与呼吸系统疾病的关系更为密切,因为要取得疗效,患者必须坚持推荐的疗法,并以适当的吸入技术正确使用吸入器。这是一项前瞻性观察研究,共纳入了 126 名年龄大于 18 岁的患者,他们不分性别,均被诊断患有阻塞性气道疾病,并被处方吸入器药物。使用吸入器依从性测试(TAI)问卷对依从性进行评估,每3个月对吸入器装置技术进行一次评估。一年后,对病情恶化次数、入院次数(包括重症监护入院)、住院天数、不良事件及其相关性等结果数据进行了分析。40.48%的患者对吸入疗法的依从性较差,其中大多数患者(69.05%)具有不知情或无知的不依从模式。在使用计量吸入器(MDI)的 75 名患者中,有 34.67% 的患者在操作技术上存在严重错误,而在使用旋转吸入器(Rotahaler)的 51 名患者中,有 23.53% 的患者在操作技术上存在严重错误。依从性水平和严重错误与性别、体重指数类别或既往吸烟史之间没有明显关系。这项研究强调了坚持治疗的作用,并找出了导致不坚持吸入治疗的障碍。这项研究强调了坚持吸入治疗的作用,并找出了不坚持吸入治疗的障碍。找出导致不坚持吸入治疗的行为,并指导患者掌握正确的吸入技术,可以改善慢性呼吸系统疾病患者的健康状况。
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Evaluation of impact of adherence to inhaled therapy and critical mistakes in inhalation technique on clinical outcomes in patients with obstructive airway diseases in India
Adherence to inhaled therapy is more relevant in respiratory diseases because, to achieve therapeutic efficacy, it is necessary that the patient adhere to the recommended therapy as well as use their inhalers correctly with appropriate inhalation technique.This was a prospective, observational study that included 126 patients >18 years of age of all genders, diagnosed with an obstructive airway disease, and prescribed inhaler medication. Adherence was assessed using the Test of Adherence to Inhalers (TAI) questionnaire, and inhaler device technique was assessed every 3 months. At the end of one year, outcome data like the number of exacerbations, the number of admissions, including critical-care admissions, the number of days of hospitalization, adverse events, and their associations were analyzed.Poor adherence to inhaled therapy was found in 40.48% of patients, with the majority of patients (69.05%) having an unwitting or ignorant pattern of non- adherence. Out of 75 patients using MDI (Metered Dose Inhaler), 34.67% had critical mistakes in technique, and out of 51 patients using Rotahaler, 23.53% had critical mistakes in technique. There was no significant relationship between level of adherence and critical mistakes with gender, BMI category, or past history of smoking. Patients with poor adherence and those with critical mistakes in inhalation technique had poor health outcomes.This study highlights the role of adherence and identifies barriers responsible for non-adherence to inhaled therapy. Identifying the behaviors responsible for non-adherence and counseling the patients on the correct inhalation technique can improve the health outcomes of chronic respiratory diseases.
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