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Ошибки при использовании различных видов ингаляционных устройств в реальной клинической практике
Ошибки при использовании различных видов ингаляционных устройств в реальной клинической практике
Трушенко Н.В., Столяревич А.А., Андрюков Б.Г., Нуралиева Г.С., Царева Н.А., Лавгинова Б.Б., Авдеев С.Н. Ошибки при использовании различных видов ингаляционных устройств в реальной клинической практике. Терапевтический архив. 2023;95(3):210–216. DOI: 10.26442/00403660.2023.03.202151
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
________________________________________________
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Аннотация
Цель. Изучение техники ингаляций при использовании различных видов ингаляционных устройств у пациентов с различными бронхообструктивными заболеваниями в реальной клинической практике.
Материалы и методы. У 110 человек со стажем использования ингаляторов более 1 мес оценивались ошибки в технике ингаляции при ее демонстрации пациентом по специальным чек-листам. У всех собраны данные по клиническим характеристикам основного заболевания, сопутствующей патологии, профилю образования, выполнена спирометрия, проведена оценка контроля астмы по ACQ-5 и удовлетворенности ингаляционным устройством по PASAPQ.
Результаты. Всего 80,9% пациентов принимали дозированные аэрозольные ингаляторы, 20,9% – капсульные порошковые ингаляторы (ПИ), 21,8% – мультидозные ПИ, 22,7% – жидкостной ингалятор. Неправильная техника ингаляции выявлена у 80,9%, 48,3% совершали 3 и более ошибки. Наибольшее число ошибок пациенты допускали при использовании дозированных аэрозольных ингаляторов (2±1,6), наименьшее – при применении жидкостного ингалятора (0,68±0,7; р=0,003). Возраст, диагноз, стаж заболевания и использования ингаляторов, профиль образования, наличие родственников, использующих ингаляторы, не влияли на технику ингаляций. При этом женский пол, одновременное использование различных типов ингаляторов увеличивали частоту ошибок, а проведение инструктажа по технике ингаляции их сокращало. Достоверная взаимосвязь выявлена между числом ошибок и объемом форсированного выдоха за 1 с, форсированной жизненной емкостью легких, выраженностью одышки по mMRC и уровнем контроля астмы. При использовании мультидозного ПИ ошибка при активации ингалятора ассоциировалась с увеличением частоты обострений основного заболевания (r=0,57; р=0,003).
Заключение. Таким образом, в реальной практике у пациентов с бронхообструктивными заболеваниями часто встречаются ошибки в технике ингаляций, оказывающие существенное влияние на клинические симптомы и функциональные показатели. Значимое влияние на технику ингаляций оказывает число одновременно используемых типов ингаляторов, а также обучение пациентов.
Ключевые слова: техника ингаляций, ингаляторы, дозированные аэрозольные ингаляторы, порошковые ингаляторы, бронхиальная астма, хроническая обструктивная болезнь легких, ХОБЛ
Materials and methods. This cross-sectional study included 110 patients with asthma, chronic obstructive pulmonary disease using the inhaler at least one month. Inhaler errors performed during demonstration were evaluated for each patient and entered in the check-lists. We also collected information about co-morbidities, education, mMRC dyspnea score, rate of exacerbations, and performed spirometry.
Results. 80.9% of patients used metered-dose inhaler, 20.9% – single-dose and 21.8% – multiple-dose dry powder inhaler, 22.7% – soft-mist inhaler. Inhaler errors were made by 80.9% patients. The mean number of mistakes in metered-dose inhaler use was 2±1.6, single-dose powder inhaler –1.5±1.3, multiple-dose dry powder inhaler – 1.25±1.4, soft-mist inhaler – 0.68±0.7 (р=0.003). Age, diagnosis, duration of disease, education level, inhalers usage by relatives have no influence on the inhalation technique. A number of errors was related to female gender (р=0.007) and usage of more than 2 inhalers (r=0.3, p=0.002), previous instruction about inhalation technique (r=0.3, p=0.001). On the other hand, there were correlations between the number of errors and degree of bronchial obstruction, asthma control, severity of dyspnea by mMRC score, exacerbation rate.
Conclusion. Patients with bronchoobstructive diseases perform many inhaler errors, that substantially influences the severity and course of asthma and chronic obstructive pulmonary disease.
Keywords: inhaler technique, metered dose inhalers, dry powder inhalers, errors, aerosols, asthma, chronic obstructive pulmonary disease, COPD
Материалы и методы. У 110 человек со стажем использования ингаляторов более 1 мес оценивались ошибки в технике ингаляции при ее демонстрации пациентом по специальным чек-листам. У всех собраны данные по клиническим характеристикам основного заболевания, сопутствующей патологии, профилю образования, выполнена спирометрия, проведена оценка контроля астмы по ACQ-5 и удовлетворенности ингаляционным устройством по PASAPQ.
Результаты. Всего 80,9% пациентов принимали дозированные аэрозольные ингаляторы, 20,9% – капсульные порошковые ингаляторы (ПИ), 21,8% – мультидозные ПИ, 22,7% – жидкостной ингалятор. Неправильная техника ингаляции выявлена у 80,9%, 48,3% совершали 3 и более ошибки. Наибольшее число ошибок пациенты допускали при использовании дозированных аэрозольных ингаляторов (2±1,6), наименьшее – при применении жидкостного ингалятора (0,68±0,7; р=0,003). Возраст, диагноз, стаж заболевания и использования ингаляторов, профиль образования, наличие родственников, использующих ингаляторы, не влияли на технику ингаляций. При этом женский пол, одновременное использование различных типов ингаляторов увеличивали частоту ошибок, а проведение инструктажа по технике ингаляции их сокращало. Достоверная взаимосвязь выявлена между числом ошибок и объемом форсированного выдоха за 1 с, форсированной жизненной емкостью легких, выраженностью одышки по mMRC и уровнем контроля астмы. При использовании мультидозного ПИ ошибка при активации ингалятора ассоциировалась с увеличением частоты обострений основного заболевания (r=0,57; р=0,003).
Заключение. Таким образом, в реальной практике у пациентов с бронхообструктивными заболеваниями часто встречаются ошибки в технике ингаляций, оказывающие существенное влияние на клинические симптомы и функциональные показатели. Значимое влияние на технику ингаляций оказывает число одновременно используемых типов ингаляторов, а также обучение пациентов.
Ключевые слова: техника ингаляций, ингаляторы, дозированные аэрозольные ингаляторы, порошковые ингаляторы, бронхиальная астма, хроническая обструктивная болезнь легких, ХОБЛ
________________________________________________
Materials and methods. This cross-sectional study included 110 patients with asthma, chronic obstructive pulmonary disease using the inhaler at least one month. Inhaler errors performed during demonstration were evaluated for each patient and entered in the check-lists. We also collected information about co-morbidities, education, mMRC dyspnea score, rate of exacerbations, and performed spirometry.
Results. 80.9% of patients used metered-dose inhaler, 20.9% – single-dose and 21.8% – multiple-dose dry powder inhaler, 22.7% – soft-mist inhaler. Inhaler errors were made by 80.9% patients. The mean number of mistakes in metered-dose inhaler use was 2±1.6, single-dose powder inhaler –1.5±1.3, multiple-dose dry powder inhaler – 1.25±1.4, soft-mist inhaler – 0.68±0.7 (р=0.003). Age, diagnosis, duration of disease, education level, inhalers usage by relatives have no influence on the inhalation technique. A number of errors was related to female gender (р=0.007) and usage of more than 2 inhalers (r=0.3, p=0.002), previous instruction about inhalation technique (r=0.3, p=0.001). On the other hand, there were correlations between the number of errors and degree of bronchial obstruction, asthma control, severity of dyspnea by mMRC score, exacerbation rate.
Conclusion. Patients with bronchoobstructive diseases perform many inhaler errors, that substantially influences the severity and course of asthma and chronic obstructive pulmonary disease.
Keywords: inhaler technique, metered dose inhalers, dry powder inhalers, errors, aerosols, asthma, chronic obstructive pulmonary disease, COPD
Полный текст
Список литературы
1. Авдеев С.Н. Интенсивная терапия в пульмонологии: монография (Серия монографий Российского респираторного общества по ред. Чучалина). М.: Атмосфера, 2014 [Avdeev SN. Intensivnaia terapiia v pulmonologii: monographiia (Seriia monographii Rossiiskogo respiratornogo obshchestva pod red. Chuchalina. Moscow, Atmosfera, 2014 (in Russian)].
2. Capstick T, Clifton I. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med. 2012;6(1):91-103. DOI:10.1586/ers.11.89
3. Sanchis J, Corrigan C, Levy M, Viejo J. Inhaler devices – From theory to practice. Respir Med. 2013;107(4):495-502. DOI:10.1016/j.rmed.2012.12.007
4. Pothirat C, Chaiwong W, Limsukon A, et al. Real-world observational study of the evaluation of inhaler techniques in asthma patients. Asian Pac J Allergy Immunol. 2021;39(2):96-102. DOI:10.12932/ap-210618-0348
5. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2019). Available at: http://www.goldcopd.org›uploads/users/files/GOLD...2019.pdf. Accessed: 21.06.2019.
6. Global strategy for asthma management and prevention, Online appendix, revised 2019. In: Global Initiative for Asthma. Available at: http://www.ginasthma.org/local/uploads/content/files/GINA_Appendix_2019_Jun11.pdf. Accessed: 02.03.2021.
7. Gregoriano C, Dieterle T, Breitenstein A, et al. Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respir Res. 2018;19(1). DOI:10.1186/s12931-018-0936-3
8. Vytrisalova M, Hendrychova T, Touskova T, et al. Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease. Front Pharmacol. 2019;10. DOI:10.3389/fphar.2019.00241
9. Mebrahtom M, Mesfin N, Gebreyesus H, Teweldemedhin M. Status of metered dose inhaler technique among patients with asthma and its effect on asthma control in Northwest Ethiopia. BMC Res Notes. 2019;12(1). DOI:10.1186/s13104-019-4059-9
10. Price D, Román-Rodríguez M, McQueen R, et al. Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017;5(4):1071-81.e9. DOI:10.1016/j.jaip.2017.01.004
11. Vargas O, Martinez J, Ibanez M, et al. The Use of Metered-Dose Inhalers in Hospital Environments. J Aerosol Med Pulm Drug Deliv. 2013;26(5):287-96. DOI:10.1089/jamp.2011.0940
12. AL-Jahdali H, Ahmed A, AL-Harbi A, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013;9(1):8. DOI:10.1186/1710-1492-9-8
13. Gregory KL, Wilken L, Hart MK. Pulmonary Disease Aerosol Delivery Devices A Guide for Physicians, Nurses, Pharmacists, and Other Health Care Professionals. 3rd ed by the American Association for Respiratory Care. 2017.
14. Melani A, Zanchetta D, Barbato N, et al. Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults. Ann Allergy, Asthma Immunol. 2004;93(5):439-46. DOI:10.1016/s1081-1206(10)61410-x
15. Jahedi L, Downie S, Saini B, et al. Inhaler Technique in Asthma: How Does It Relate to Patients' Preferences and Attitudes Toward Their Inhalers? J Aerosol Med Pulm Drug Deliv. 2017;30(1):42-52. DOI:10.1089/jamp.2016.1287
16. Rootmensen G, van Keimpema A, Jansen H, de Haan R. Predictors of Incorrect Inhalation Technique in Patients with Asthma or COPD: A Study Using a Validated Videotaped Scoring Method. J Aerosol Med Pulm Drug Deliv. 2010;23(5):323-8. DOI:10.1089/jamp.2009.0785
17. Usmani O, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. DOI:10.1186/s12931-017-0710-y
18. Dalcin P, Grutcki D, Laporte P, et al. Factors related to the incorrect use of inhalers by asthma patients. J Bras Pneumol. 2014;40(1):13-20. DOI:10.1590/s1806-37132014000100003
19. Dolovich M, Ahrens R, Hess D, et al. Device Selection and Outcomes of Aerosol Therapy: Evidence-Based Guidelines. Chest. 2005;127(1):335-71. DOI:10.1378/chest.127.1.335
20. Australia NAC: Australian Asthma Handbook, Vol Version 1.1. National Asthma Council Australia, Melbourne, pg. 23. 2015.
21. Souza M, Meneghini A, Ferraz É, et al. Knowledge of and technique for using inhalation devices among asthma patients and COPD patients. J Bras Pneumol. 2009;35(9):824-31. DOI:10.1590/s1806-37132009000900002
22. Melani A, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-8. DOI:10.1016/j.rmed.2011.01.005
23. Miravitlles M, Montero-Caballero J, Richard F, et al. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD. Int J Chron Obstruct Pulmon Dis. 2016:407. DOI:10.2147/copd.s91118
24. Davis K, Su J, González JM, et al. Quantifying the importance of inhaler attributes corresponding to items in the patient satisfaction and preference questionnaire in patients using Combivent Respimat. Health Qual Life Outcomes. 2017;15(1):201. DOI:10.1186/s12955-017-0780-z
25. Kozma C, Slaton T, Monz B, et al. Development and Validation of a Patient Satisfaction and Preference Questionnaire for Inhalation Devices. Treat Respir Med. 2005;4(1):41-52. DOI:10.2165/00151829-200504010-00005
26. Yildiz F. Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study. Respir Care. 2013;59(2):223-30. DOI:10.4187/respcare.02478
27. Khurana A, Dubey K, Goyal A, et al. Correcting inhaler technique decreases severity of obstruction and improves quality of life among patients with obstructive airway disease. J Family Med Prim Care. 2019;8(1):246. DOI:10.4103/jfmpc.jfmpc_259_18
28. Martínez Ibán M, Alonso Porcel C, Sánchez Rodríguez L, et al. Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease. Semergen. 2019;45(1):15-22 (in Spanish). DOI:10.1016/j.semerg.2018.04.009
29. Camilleri K, Balzan M, Pace Bardon M, et al. Predictors of good inhaler technique in asthma and COPD. 51 Airway Pharmacology and Treatment. 2015. DOI:10.1183/13993003.congress-2015.pa3928
30. Pothirat C, Chaiwong W, Phetsuk N, et al. Evaluating inhaler use technique in COPD patients. Int J Chron Obstruct Pulmon Dis. 2015;10:1291-8. DOI:10.2147/copd.s85681
31. Westerik J, Carter V, Chrystyn H, et al. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting. J Asthma. 2016;53(3):321-9. DOI:10.3109/02770903.2015.1099160
32. Chorão P, Pereira A, Fonseca J. Inhaler devices in asthma and COPD – An assessment of inhaler technique and patient preferences. Respir Med. 2014;108(7):968-75. DOI:10.1016/j.rmed.2014.04.019
33. Freitas Ferreira E, Pascoal A, Silva P, et al. Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patients. J Asthma. 2019:1-11. DOI:10.1080/02770903.2019.1582063
34. Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa J. COPD: misuse of inhaler devices in clinical practice. Int J Chron Obstruct Pulmon Dis. 2019;14:1209-17. DOI:10.2147/copd.s178040
2. Capstick T, Clifton I. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med. 2012;6(1):91-103. DOI:10.1586/ers.11.89
3. Sanchis J, Corrigan C, Levy M, Viejo J. Inhaler devices – From theory to practice. Respir Med. 2013;107(4):495-502. DOI:10.1016/j.rmed.2012.12.007
4. Pothirat C, Chaiwong W, Limsukon A, et al. Real-world observational study of the evaluation of inhaler techniques in asthma patients. Asian Pac J Allergy Immunol. 2021;39(2):96-102. DOI:10.12932/ap-210618-0348
5. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2019). Available at: http://www.goldcopd.org›uploads/users/files/GOLD...2019.pdf. Accessed: 21.06.2019.
6. Global strategy for asthma management and prevention, Online appendix, revised 2019. In: Global Initiative for Asthma. Available at: http://www.ginasthma.org/local/uploads/content/files/GINA_Appendix_2019_Jun11.pdf. Accessed: 02.03.2021.
7. Gregoriano C, Dieterle T, Breitenstein A, et al. Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respir Res. 2018;19(1). DOI:10.1186/s12931-018-0936-3
8. Vytrisalova M, Hendrychova T, Touskova T, et al. Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease. Front Pharmacol. 2019;10. DOI:10.3389/fphar.2019.00241
9. Mebrahtom M, Mesfin N, Gebreyesus H, Teweldemedhin M. Status of metered dose inhaler technique among patients with asthma and its effect on asthma control in Northwest Ethiopia. BMC Res Notes. 2019;12(1). DOI:10.1186/s13104-019-4059-9
10. Price D, Román-Rodríguez M, McQueen R, et al. Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017;5(4):1071-81.e9. DOI:10.1016/j.jaip.2017.01.004
11. Vargas O, Martinez J, Ibanez M, et al. The Use of Metered-Dose Inhalers in Hospital Environments. J Aerosol Med Pulm Drug Deliv. 2013;26(5):287-96. DOI:10.1089/jamp.2011.0940
12. AL-Jahdali H, Ahmed A, AL-Harbi A, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013;9(1):8. DOI:10.1186/1710-1492-9-8
13. Gregory KL, Wilken L, Hart MK. Pulmonary Disease Aerosol Delivery Devices A Guide for Physicians, Nurses, Pharmacists, and Other Health Care Professionals. 3rd ed by the American Association for Respiratory Care. 2017.
14. Melani A, Zanchetta D, Barbato N, et al. Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults. Ann Allergy, Asthma Immunol. 2004;93(5):439-46. DOI:10.1016/s1081-1206(10)61410-x
15. Jahedi L, Downie S, Saini B, et al. Inhaler Technique in Asthma: How Does It Relate to Patients' Preferences and Attitudes Toward Their Inhalers? J Aerosol Med Pulm Drug Deliv. 2017;30(1):42-52. DOI:10.1089/jamp.2016.1287
16. Rootmensen G, van Keimpema A, Jansen H, de Haan R. Predictors of Incorrect Inhalation Technique in Patients with Asthma or COPD: A Study Using a Validated Videotaped Scoring Method. J Aerosol Med Pulm Drug Deliv. 2010;23(5):323-8. DOI:10.1089/jamp.2009.0785
17. Usmani O, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. DOI:10.1186/s12931-017-0710-y
18. Dalcin P, Grutcki D, Laporte P, et al. Factors related to the incorrect use of inhalers by asthma patients. J Bras Pneumol. 2014;40(1):13-20. DOI:10.1590/s1806-37132014000100003
19. Dolovich M, Ahrens R, Hess D, et al. Device Selection and Outcomes of Aerosol Therapy: Evidence-Based Guidelines. Chest. 2005;127(1):335-71. DOI:10.1378/chest.127.1.335
20. Australia NAC: Australian Asthma Handbook, Vol Version 1.1. National Asthma Council Australia, Melbourne, pg. 23. 2015.
21. Souza M, Meneghini A, Ferraz É, et al. Knowledge of and technique for using inhalation devices among asthma patients and COPD patients. J Bras Pneumol. 2009;35(9):824-31. DOI:10.1590/s1806-37132009000900002
22. Melani A, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-8. DOI:10.1016/j.rmed.2011.01.005
23. Miravitlles M, Montero-Caballero J, Richard F, et al. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD. Int J Chron Obstruct Pulmon Dis. 2016:407. DOI:10.2147/copd.s91118
24. Davis K, Su J, González JM, et al. Quantifying the importance of inhaler attributes corresponding to items in the patient satisfaction and preference questionnaire in patients using Combivent Respimat. Health Qual Life Outcomes. 2017;15(1):201. DOI:10.1186/s12955-017-0780-z
25. Kozma C, Slaton T, Monz B, et al. Development and Validation of a Patient Satisfaction and Preference Questionnaire for Inhalation Devices. Treat Respir Med. 2005;4(1):41-52. DOI:10.2165/00151829-200504010-00005
26. Yildiz F. Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study. Respir Care. 2013;59(2):223-30. DOI:10.4187/respcare.02478
27. Khurana A, Dubey K, Goyal A, et al. Correcting inhaler technique decreases severity of obstruction and improves quality of life among patients with obstructive airway disease. J Family Med Prim Care. 2019;8(1):246. DOI:10.4103/jfmpc.jfmpc_259_18
28. Martínez Ibán M, Alonso Porcel C, Sánchez Rodríguez L, et al. Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease. Semergen. 2019;45(1):15-22 (in Spanish). DOI:10.1016/j.semerg.2018.04.009
29. Camilleri K, Balzan M, Pace Bardon M, et al. Predictors of good inhaler technique in asthma and COPD. 51 Airway Pharmacology and Treatment. 2015. DOI:10.1183/13993003.congress-2015.pa3928
30. Pothirat C, Chaiwong W, Phetsuk N, et al. Evaluating inhaler use technique in COPD patients. Int J Chron Obstruct Pulmon Dis. 2015;10:1291-8. DOI:10.2147/copd.s85681
31. Westerik J, Carter V, Chrystyn H, et al. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting. J Asthma. 2016;53(3):321-9. DOI:10.3109/02770903.2015.1099160
32. Chorão P, Pereira A, Fonseca J. Inhaler devices in asthma and COPD – An assessment of inhaler technique and patient preferences. Respir Med. 2014;108(7):968-75. DOI:10.1016/j.rmed.2014.04.019
33. Freitas Ferreira E, Pascoal A, Silva P, et al. Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patients. J Asthma. 2019:1-11. DOI:10.1080/02770903.2019.1582063
34. Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa J. COPD: misuse of inhaler devices in clinical practice. Int J Chron Obstruct Pulmon Dis. 2019;14:1209-17. DOI:10.2147/copd.s178040
2. Capstick T, Clifton I. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med. 2012;6(1):91-103. DOI:10.1586/ers.11.89
3. Sanchis J, Corrigan C, Levy M, Viejo J. Inhaler devices – From theory to practice. Respir Med. 2013;107(4):495-502. DOI:10.1016/j.rmed.2012.12.007
4. Pothirat C, Chaiwong W, Limsukon A, et al. Real-world observational study of the evaluation of inhaler techniques in asthma patients. Asian Pac J Allergy Immunol. 2021;39(2):96-102. DOI:10.12932/ap-210618-0348
5. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2019). Available at: http://www.goldcopd.org›uploads/users/files/GOLD...2019.pdf. Accessed: 21.06.2019.
6. Global strategy for asthma management and prevention, Online appendix, revised 2019. In: Global Initiative for Asthma. Available at: http://www.ginasthma.org/local/uploads/content/files/GINA_Appendix_2019_Jun11.pdf. Accessed: 02.03.2021.
7. Gregoriano C, Dieterle T, Breitenstein A, et al. Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respir Res. 2018;19(1). DOI:10.1186/s12931-018-0936-3
8. Vytrisalova M, Hendrychova T, Touskova T, et al. Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease. Front Pharmacol. 2019;10. DOI:10.3389/fphar.2019.00241
9. Mebrahtom M, Mesfin N, Gebreyesus H, Teweldemedhin M. Status of metered dose inhaler technique among patients with asthma and its effect on asthma control in Northwest Ethiopia. BMC Res Notes. 2019;12(1). DOI:10.1186/s13104-019-4059-9
10. Price D, Román-Rodríguez M, McQueen R, et al. Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017;5(4):1071-81.e9. DOI:10.1016/j.jaip.2017.01.004
11. Vargas O, Martinez J, Ibanez M, et al. The Use of Metered-Dose Inhalers in Hospital Environments. J Aerosol Med Pulm Drug Deliv. 2013;26(5):287-96. DOI:10.1089/jamp.2011.0940
12. AL-Jahdali H, Ahmed A, AL-Harbi A, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013;9(1):8. DOI:10.1186/1710-1492-9-8
13. Gregory KL, Wilken L, Hart MK. Pulmonary Disease Aerosol Delivery Devices A Guide for Physicians, Nurses, Pharmacists, and Other Health Care Professionals. 3rd ed by the American Association for Respiratory Care. 2017.
14. Melani A, Zanchetta D, Barbato N, et al. Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults. Ann Allergy, Asthma Immunol. 2004;93(5):439-46. DOI:10.1016/s1081-1206(10)61410-x
15. Jahedi L, Downie S, Saini B, et al. Inhaler Technique in Asthma: How Does It Relate to Patients' Preferences and Attitudes Toward Their Inhalers? J Aerosol Med Pulm Drug Deliv. 2017;30(1):42-52. DOI:10.1089/jamp.2016.1287
16. Rootmensen G, van Keimpema A, Jansen H, de Haan R. Predictors of Incorrect Inhalation Technique in Patients with Asthma or COPD: A Study Using a Validated Videotaped Scoring Method. J Aerosol Med Pulm Drug Deliv. 2010;23(5):323-8. DOI:10.1089/jamp.2009.0785
17. Usmani O, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. DOI:10.1186/s12931-017-0710-y
18. Dalcin P, Grutcki D, Laporte P, et al. Factors related to the incorrect use of inhalers by asthma patients. J Bras Pneumol. 2014;40(1):13-20. DOI:10.1590/s1806-37132014000100003
19. Dolovich M, Ahrens R, Hess D, et al. Device Selection and Outcomes of Aerosol Therapy: Evidence-Based Guidelines. Chest. 2005;127(1):335-71. DOI:10.1378/chest.127.1.335
20. Australia NAC: Australian Asthma Handbook, Vol Version 1.1. National Asthma Council Australia, Melbourne, pg. 23. 2015.
21. Souza M, Meneghini A, Ferraz É, et al. Knowledge of and technique for using inhalation devices among asthma patients and COPD patients. J Bras Pneumol. 2009;35(9):824-31. DOI:10.1590/s1806-37132009000900002
22. Melani A, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-8. DOI:10.1016/j.rmed.2011.01.005
23. Miravitlles M, Montero-Caballero J, Richard F, et al. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD. Int J Chron Obstruct Pulmon Dis. 2016:407. DOI:10.2147/copd.s91118
24. Davis K, Su J, González JM, et al. Quantifying the importance of inhaler attributes corresponding to items in the patient satisfaction and preference questionnaire in patients using Combivent Respimat. Health Qual Life Outcomes. 2017;15(1):201. DOI:10.1186/s12955-017-0780-z
25. Kozma C, Slaton T, Monz B, et al. Development and Validation of a Patient Satisfaction and Preference Questionnaire for Inhalation Devices. Treat Respir Med. 2005;4(1):41-52. DOI:10.2165/00151829-200504010-00005
26. Yildiz F. Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study. Respir Care. 2013;59(2):223-30. DOI:10.4187/respcare.02478
27. Khurana A, Dubey K, Goyal A, et al. Correcting inhaler technique decreases severity of obstruction and improves quality of life among patients with obstructive airway disease. J Family Med Prim Care. 2019;8(1):246. DOI:10.4103/jfmpc.jfmpc_259_18
28. Martínez Ibán M, Alonso Porcel C, Sánchez Rodríguez L, et al. Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease. Semergen. 2019;45(1):15-22 (in Spanish). DOI:10.1016/j.semerg.2018.04.009
29. Camilleri K, Balzan M, Pace Bardon M, et al. Predictors of good inhaler technique in asthma and COPD. 51 Airway Pharmacology and Treatment. 2015. DOI:10.1183/13993003.congress-2015.pa3928
30. Pothirat C, Chaiwong W, Phetsuk N, et al. Evaluating inhaler use technique in COPD patients. Int J Chron Obstruct Pulmon Dis. 2015;10:1291-8. DOI:10.2147/copd.s85681
31. Westerik J, Carter V, Chrystyn H, et al. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting. J Asthma. 2016;53(3):321-9. DOI:10.3109/02770903.2015.1099160
32. Chorão P, Pereira A, Fonseca J. Inhaler devices in asthma and COPD – An assessment of inhaler technique and patient preferences. Respir Med. 2014;108(7):968-75. DOI:10.1016/j.rmed.2014.04.019
33. Freitas Ferreira E, Pascoal A, Silva P, et al. Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patients. J Asthma. 2019:1-11. DOI:10.1080/02770903.2019.1582063
34. Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa J. COPD: misuse of inhaler devices in clinical practice. Int J Chron Obstruct Pulmon Dis. 2019;14:1209-17. DOI:10.2147/copd.s178040
________________________________________________
2. Capstick T, Clifton I. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med. 2012;6(1):91-103. DOI:10.1586/ers.11.89
3. Sanchis J, Corrigan C, Levy M, Viejo J. Inhaler devices – From theory to practice. Respir Med. 2013;107(4):495-502. DOI:10.1016/j.rmed.2012.12.007
4. Pothirat C, Chaiwong W, Limsukon A, et al. Real-world observational study of the evaluation of inhaler techniques in asthma patients. Asian Pac J Allergy Immunol. 2021;39(2):96-102. DOI:10.12932/ap-210618-0348
5. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2019). Available at: http://www.goldcopd.org›uploads/users/files/GOLD...2019.pdf. Accessed: 21.06.2019.
6. Global strategy for asthma management and prevention, Online appendix, revised 2019. In: Global Initiative for Asthma. Available at: http://www.ginasthma.org/local/uploads/content/files/GINA_Appendix_2019_Jun11.pdf. Accessed: 02.03.2021.
7. Gregoriano C, Dieterle T, Breitenstein A, et al. Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respir Res. 2018;19(1). DOI:10.1186/s12931-018-0936-3
8. Vytrisalova M, Hendrychova T, Touskova T, et al. Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease. Front Pharmacol. 2019;10. DOI:10.3389/fphar.2019.00241
9. Mebrahtom M, Mesfin N, Gebreyesus H, Teweldemedhin M. Status of metered dose inhaler technique among patients with asthma and its effect on asthma control in Northwest Ethiopia. BMC Res Notes. 2019;12(1). DOI:10.1186/s13104-019-4059-9
10. Price D, Román-Rodríguez M, McQueen R, et al. Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017;5(4):1071-81.e9. DOI:10.1016/j.jaip.2017.01.004
11. Vargas O, Martinez J, Ibanez M, et al. The Use of Metered-Dose Inhalers in Hospital Environments. J Aerosol Med Pulm Drug Deliv. 2013;26(5):287-96. DOI:10.1089/jamp.2011.0940
12. AL-Jahdali H, Ahmed A, AL-Harbi A, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013;9(1):8. DOI:10.1186/1710-1492-9-8
13. Gregory KL, Wilken L, Hart MK. Pulmonary Disease Aerosol Delivery Devices A Guide for Physicians, Nurses, Pharmacists, and Other Health Care Professionals. 3rd ed by the American Association for Respiratory Care. 2017.
14. Melani A, Zanchetta D, Barbato N, et al. Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults. Ann Allergy, Asthma Immunol. 2004;93(5):439-46. DOI:10.1016/s1081-1206(10)61410-x
15. Jahedi L, Downie S, Saini B, et al. Inhaler Technique in Asthma: How Does It Relate to Patients' Preferences and Attitudes Toward Their Inhalers? J Aerosol Med Pulm Drug Deliv. 2017;30(1):42-52. DOI:10.1089/jamp.2016.1287
16. Rootmensen G, van Keimpema A, Jansen H, de Haan R. Predictors of Incorrect Inhalation Technique in Patients with Asthma or COPD: A Study Using a Validated Videotaped Scoring Method. J Aerosol Med Pulm Drug Deliv. 2010;23(5):323-8. DOI:10.1089/jamp.2009.0785
17. Usmani O, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. DOI:10.1186/s12931-017-0710-y
18. Dalcin P, Grutcki D, Laporte P, et al. Factors related to the incorrect use of inhalers by asthma patients. J Bras Pneumol. 2014;40(1):13-20. DOI:10.1590/s1806-37132014000100003
19. Dolovich M, Ahrens R, Hess D, et al. Device Selection and Outcomes of Aerosol Therapy: Evidence-Based Guidelines. Chest. 2005;127(1):335-71. DOI:10.1378/chest.127.1.335
20. Australia NAC: Australian Asthma Handbook, Vol Version 1.1. National Asthma Council Australia, Melbourne, pg. 23. 2015.
21. Souza M, Meneghini A, Ferraz É, et al. Knowledge of and technique for using inhalation devices among asthma patients and COPD patients. J Bras Pneumol. 2009;35(9):824-31. DOI:10.1590/s1806-37132009000900002
22. Melani A, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-8. DOI:10.1016/j.rmed.2011.01.005
23. Miravitlles M, Montero-Caballero J, Richard F, et al. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD. Int J Chron Obstruct Pulmon Dis. 2016:407. DOI:10.2147/copd.s91118
24. Davis K, Su J, González JM, et al. Quantifying the importance of inhaler attributes corresponding to items in the patient satisfaction and preference questionnaire in patients using Combivent Respimat. Health Qual Life Outcomes. 2017;15(1):201. DOI:10.1186/s12955-017-0780-z
25. Kozma C, Slaton T, Monz B, et al. Development and Validation of a Patient Satisfaction and Preference Questionnaire for Inhalation Devices. Treat Respir Med. 2005;4(1):41-52. DOI:10.2165/00151829-200504010-00005
26. Yildiz F. Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study. Respir Care. 2013;59(2):223-30. DOI:10.4187/respcare.02478
27. Khurana A, Dubey K, Goyal A, et al. Correcting inhaler technique decreases severity of obstruction and improves quality of life among patients with obstructive airway disease. J Family Med Prim Care. 2019;8(1):246. DOI:10.4103/jfmpc.jfmpc_259_18
28. Martínez Ibán M, Alonso Porcel C, Sánchez Rodríguez L, et al. Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease. Semergen. 2019;45(1):15-22 (in Spanish). DOI:10.1016/j.semerg.2018.04.009
29. Camilleri K, Balzan M, Pace Bardon M, et al. Predictors of good inhaler technique in asthma and COPD. 51 Airway Pharmacology and Treatment. 2015. DOI:10.1183/13993003.congress-2015.pa3928
30. Pothirat C, Chaiwong W, Phetsuk N, et al. Evaluating inhaler use technique in COPD patients. Int J Chron Obstruct Pulmon Dis. 2015;10:1291-8. DOI:10.2147/copd.s85681
31. Westerik J, Carter V, Chrystyn H, et al. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting. J Asthma. 2016;53(3):321-9. DOI:10.3109/02770903.2015.1099160
32. Chorão P, Pereira A, Fonseca J. Inhaler devices in asthma and COPD – An assessment of inhaler technique and patient preferences. Respir Med. 2014;108(7):968-75. DOI:10.1016/j.rmed.2014.04.019
33. Freitas Ferreira E, Pascoal A, Silva P, et al. Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patients. J Asthma. 2019:1-11. DOI:10.1080/02770903.2019.1582063
34. Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa J. COPD: misuse of inhaler devices in clinical practice. Int J Chron Obstruct Pulmon Dis. 2019;14:1209-17. DOI:10.2147/copd.s178040
Авторы
Н.В. Трушенко*1,2, А.А. Столяревич3, Б.Г. Андрюков4, Г.С. Нуралиева1,2, Н.А. Царева1,2, Б.Б. Лавгинова1, С.Н. Авдеев1,2
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБУ «Научно-исследовательский институт пульмонологии» ФМБА России, Москва, Россия;
3 ГБУЗ «Городская клиническая больница им. С. П. Боткина» Департамента здравоохранения г. Москвы, Москва, Россия;
4 ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ, Москва, Россия
*trushenko.natalia@yandex.ru
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Federal Pulmonology Research Institute, Moscow, Russia;
3 Botkin City Clinical Hospital, Moscow, Russia;
4 Central State Medical Academy Presidential Administration, Moscow, Russia
*trushenko.natalia@yandex.ru
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБУ «Научно-исследовательский институт пульмонологии» ФМБА России, Москва, Россия;
3 ГБУЗ «Городская клиническая больница им. С. П. Боткина» Департамента здравоохранения г. Москвы, Москва, Россия;
4 ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ, Москва, Россия
*trushenko.natalia@yandex.ru
________________________________________________
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Federal Pulmonology Research Institute, Moscow, Russia;
3 Botkin City Clinical Hospital, Moscow, Russia;
4 Central State Medical Academy Presidential Administration, Moscow, Russia
*trushenko.natalia@yandex.ru
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