PDF(Pubmed)
Abstract：
BACKGROUND: Inhaler education for patients with asthma and patients with COPD is typically provided by non-pulmonologists. We studied inhaler education by pulmonologists to determine changes in clinical outcomes and inhaler use.
METHODS: This was a retrospective study of 296 subjects diagnosed with asthma, COPD, or both that evaluated use of inhaler technique education and its impact on (1) inhaler/dosage change consisting of dosage change in the same class of inhaler and/or change in number of inhalers, (2) forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), (3) disease symptom control, (4) out-patient visits, (5) urgent care visits (6) emergency department visits, and (7) hospital admissions. One group received inhaler technique education by a pulmonologist while the other group did not.
RESULTS: The pulmonologist inhaler technique-educated group had significantly decreased relative risk for inhaler/dosage increase (relative risk 0.57 [95% CI 0.34-0.96], P = .03) and significantly increased odds for symptom control (odds ratio 2.15 [95% CI 1.24-3.74], P = .01) at 1-y follow-up as compared to the no education group. No differences occurred for FEV1/FVC%, out-patient visits, urgent care visits, emergency department visits, and hospital admissions.
CONCLUSIONS: Pulmonologist education of inhaler technique for patients with asthma and patients with COPD was associated with decreased relative risk for inhaler/dosage increase and increased odds for symptom control. We recommend pulmonologists provide education of inhaler technique to patients with asthma and patients with COPD and not rely on non-pulmonologist education alone. Prospective research is needed to confirm the importance of proper inhaler techniques.
METHODS: This was a retrospective study of 296 subjects diagnosed with asthma, COPD, or both that evaluated use of inhaler technique education and its impact on (1) inhaler/dosage change consisting of dosage change in the same class of inhaler and/or change in number of inhalers, (2) forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), (3) disease symptom control, (4) out-patient visits, (5) urgent care visits (6) emergency department visits, and (7) hospital admissions. One group received inhaler technique education by a pulmonologist while the other group did not.
RESULTS: The pulmonologist inhaler technique-educated group had significantly decreased relative risk for inhaler/dosage increase (relative risk 0.57 [95% CI 0.34-0.96], P = .03) and significantly increased odds for symptom control (odds ratio 2.15 [95% CI 1.24-3.74], P = .01) at 1-y follow-up as compared to the no education group. No differences occurred for FEV1/FVC%, out-patient visits, urgent care visits, emergency department visits, and hospital admissions.
CONCLUSIONS: Pulmonologist education of inhaler technique for patients with asthma and patients with COPD was associated with decreased relative risk for inhaler/dosage increase and increased odds for symptom control. We recommend pulmonologists provide education of inhaler technique to patients with asthma and patients with COPD and not rely on non-pulmonologist education alone. Prospective research is needed to confirm the importance of proper inhaler techniques.
摘要：
背景：哮喘患者和COPD患者的吸入器教育通常由非肺科医师提供。我们研究了肺科医师对吸入器的教育，以确定临床结果和吸入器使用的变化。
方法：这是一项对296名被诊断为哮喘的受试者进行的回顾性研究，COPD,或评估吸入器技术教育的使用及其对(1)吸入器/剂量变化的影响，包括同一类吸入器的剂量变化和/或吸入器数量的变化，(2)一秒用力呼气量/用力肺活量(FEV1/FVC%),(3)疾病症状控制,(4)门诊就诊,（5）紧急护理访视（6）急诊科访视，（7）住院。一组接受了肺科医师的吸入器技术培训，而另一组则没有。
结果：接受过肺科医师吸入器技术培训的组吸入器/剂量增加的相对风险显着降低（相对风险比0.57[95％CI0.34-0.96]，P=0.03），症状控制的几率显着增加（赔率2.15[95%CI1.24-3.74]，与无教育组相比，1-y随访时P=0.01）。FEV1/FVC%无差异,门诊就诊,紧急护理访问，急诊部门的访问，和入院。
结论：肺科医师对哮喘和COPD患者吸入器技术的教育与吸入器/剂量增加的相对风险降低和症状控制的几率增加相关。我们建议肺科医师为哮喘患者和COPD患者提供吸入器技术教育，而不是仅仅依靠非肺科医师的教育。需要进行前瞻性研究以确认适当吸入器技术的重要性。
方法：这是一项对296名被诊断为哮喘的受试者进行的回顾性研究，COPD,或评估吸入器技术教育的使用及其对(1)吸入器/剂量变化的影响，包括同一类吸入器的剂量变化和/或吸入器数量的变化，(2)一秒用力呼气量/用力肺活量(FEV1/FVC%),(3)疾病症状控制,(4)门诊就诊,（5）紧急护理访视（6）急诊科访视，（7）住院。一组接受了肺科医师的吸入器技术培训，而另一组则没有。
结果：接受过肺科医师吸入器技术培训的组吸入器/剂量增加的相对风险显着降低（相对风险比0.57[95％CI0.34-0.96]，P=0.03），症状控制的几率显着增加（赔率2.15[95%CI1.24-3.74]，与无教育组相比，1-y随访时P=0.01）。FEV1/FVC%无差异,门诊就诊,紧急护理访问，急诊部门的访问，和入院。
结论：肺科医师对哮喘和COPD患者吸入器技术的教育与吸入器/剂量增加的相对风险降低和症状控制的几率增加相关。我们建议肺科医师为哮喘患者和COPD患者提供吸入器技术教育，而不是仅仅依靠非肺科医师的教育。需要进行前瞻性研究以确认适当吸入器技术的重要性。
