哮喘和慢性阻塞性肺病急性加重门诊急诊患者的临床概况、吸入器使用技巧以及吸入器依从性的预测因素。

IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Internal and Emergency Medicine Pub Date : 2025-09-01 Epub Date: 2024-11-05 DOI:10.1007/s11739-024-03810-5
Hock Peng Koh, Paula Suen Suen Teoh, Nurul Liana Roslan
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引用次数: 0

摘要

要实现哮喘和慢性阻塞性肺病(COPD)的治疗目标,了解患者的临床概况、最佳使用吸入器的障碍以及坚持使用吸入器的情况至关重要。本研究旨在评估急诊科(ED)哮喘和慢性阻塞性肺病患者的吸入器使用技巧,并确定吸入器依从性的预测因素。这项前瞻性横断面研究招募了2022年3月至2023年2月期间因轻度至中度病情加重而到一家三甲医院门诊急诊科就诊的患者。本研究采用了便利抽样法。对所有受试者的吸入器技术和依从性进行了评估。回归分析用于确定吸入器依从性的预测因素。我们招募了 120 名受试者,平均年龄(47.8 ± 16.0),主要是哮喘患者(85 人,70.8%)。大多数受试者定期复诊(72 人,60.0%),并坚持使用吸入器(86 人,71.7%)。正确使用吸入器的受试者不到一半(人数=45,37.5%)。研究发现了三个预测吸入器依从性的因素:定期随访(aOR 2.072,p = 0.041)、正确的吸入器使用技巧(aOR 3.071,p = 0.039)和解释吸入器作用方式的能力(aOR 10.906,p = 0.031)。哮喘和慢性阻塞性肺病患者使用错误吸入器的比例之高令人担忧。在管理这类患者时,应针对吸入器依从性的预测因素进行识别。除了在急诊室对病情加重的患者进行治疗外,转诊到公共初级保健诊所进行定期随访、评估吸入器使用技巧以及提供咨询以增强患者的知识也至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical profile, inhaler technique, and predictors of inhaler adherence among asthma and COPD patients who attended the outpatient emergency department for acute exacerbation.

Understanding the patients' clinical profile, barriers to optimal inhaler use, and adherence are crucial in achieving the treatment goal for asthma and chronic obstructive pulmonary disease (COPD). This study aimed to assess the inhaler technique and identify the predictors of inhaler adherence among asthma and COPD patients who presented to the Emergency Department (ED). This prospective cross-sectional study recruited patients who presented to the outpatient ED of a tertiary hospital for mild-to-moderate exacerbation from March 2022 to February 2023. Convenience sampling was used in this study. The inhaler techniques and adherence of all subjects were evaluated. Regression analysis was used to identify predictors of inhaler adherence. We recruited 120 subjects with a mean age of 47.8 ± 16.0 and were predominantly asthma patients (n = 85, 70.8%). Most were on regular follow-up (n = 72, 60.0%) and adhered to their inhaler(s) (n = 86, 71.7%). Less than half of the subjects use their inhaler(s) correctly (n = 45, 37.5%). Three predictors of inhaler adherence were identified: regular follow-up (aOR 2.072, p = 0.041), correct inhaler technique (aOR 3.071, p = 0.039), and ability to explain inhalers' mode of action (aOR 10.906, p = 0.031). The high rate of wrong inhaler techniques among asthma and COPD patients is worrisome. Identified predictors of inhaler adherence should be targeted when managing this group of patients. In addition to the exacerbation treatment in the ED, referrals to public primary health clinics for regular follow-ups, evaluation of inhaler techniques, and counseling to enhance patient knowledge are crucial.

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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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