哮喘和慢性阻塞性肺疾病管理的当代挑战:通过指南实施、吸入器选择和患者参与优化结果的专家观点

Tuula Vasankari, Federico Lavorini, Christer Janson, L. Lehtimäki, Eric Bateman, Dave Singh, C. Ulrik, Ashley Woodcock, Alvar Agustí
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引用次数: 0

摘要

哮喘和慢性阻塞性肺疾病(COPD)影响着整个欧洲数百万人,是该大陆主要的死亡原因之一。这两种情况也对患者造成相当大的发病率,对个人的身心健康及其正常生活和工作的能力产生不利影响。哮喘和慢性阻塞性肺病还通过直接和间接的医疗费用给卫生保健提供者和更广泛的社会带来了沉重的经济负担。几十年来,吸入剂治疗一直是成功治疗这两种疾病的关键。器械技术的进步和对这两种疾病病理生理学的理解(同时在理论上为吸入疗法引入了更大的灵活性和反应性)也增加了识别最适合个体患者需求的药物和输送装置的精确组合的复杂性,有时甚至是混乱。最近发表的多国共识报告为哮喘和慢性阻塞性肺病的管理制定了最佳实践框架。本报告总结的两个专题讨论会的报告审查了这些指南对治疗这两种疾病的影响。与会者特别关注干动力吸入器作为一种提供有效治疗的手段,它既易于使用,又为患者广泛接受,而且与加压计量吸入器相比,有可能减少与医疗有关的温室气体排放。作者强调了患者伙伴关系在确定护理计划中的重要性,包括吸入器装置和治疗的选择;定期监测哮喘和慢性阻塞性肺病患者治疗依从性的益处;简单的好处是,在可能的情况下使用一种吸入器,以尽量减少吸入技术中的关键错误。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contemporary Challenges in the Management of Asthma and Chronic Obstructive Pulmonary Disease: Expert Perspectives on Optimising Outcomes Through Guidelines Implementation, Inhaler Selection, and Patient Engagement
Asthma and chronic obstructive pulmonary disease (COPD) affect millions of people throughout Europe, being one of the leading causes of death in the continent. Both conditions also impose considerable morbidity on patients, adversely affecting individuals’ physical and psychological wellbeing, and their capacity to live and work normally. Asthma and COPD also impose a substantial economic burden on healthcare providers and wider society through both direct and indirect costs of care. Inhaler-delivered therapy has been central to the successful management of both conditions for several decades. Advances in device technology and understanding of the pathophysiology of both conditions (while theoretically introducing greater flexibility and responsiveness into the repertoire of inhalation therapies) have also added complexity and sometimes confusion into the task of identifying the precise combination of medication and delivery device best suited to the needs of individual patients. Recently published multinational consensus reports have set out best-practice frameworks for the management of both asthma and COPD. Presentations at the two symposia summarised in this report examined the implications of these guidelines for the treatment of both conditions. Special focus was on dry power inhalers (DPI) as a means of delivering effective treatment that combines ease of use and widespread acceptance among patients, with the potential to reduce medically-related emissions of greenhouses gases compared with pressurised metered-dose inhalers (pMDI). The authors emphasised the importance of patient partnership in determining the care plan, including the choice of both inhaler device and treatment; the benefits of regular monitoring of adherence to the treatment for both patients with asthma and COPD; and the benefits of simplicity, using one type of inhaler where possible to minimise critical errors in inhalation technique.
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