科研之友
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摘要
Background: Chronic obstructive pulmonary disease(COPD) is a leading cause of mortality and disability worldwide. Inhaled medication is the mainstay of COPD management, but inhaler mishandling remains common and is associated with reduced disease control. To date, few studies have investigated factors affecting incorrect use of dry powder inhalers(DPIs) in patients with COPD. Objective: To investigate the prevalence of incorrect use of DPIs and associated factors in stable COPD outpatients, putting forward targeted intervention strategies. Methods: From March to August 2018, 91 adult outpatients with stable COPD form Cardiopulmonology Department, Xianhu Hospital, the First Affiliated Hospital of Guangxi University of Chinese Medicine were included. Incorrect use of DPIs among them were analyzed, and possible risk factors were explored by Logistic analysis. Results: The overall prevalence of incorrect use of DPIs was 42.9%(39/91). The three most common types of incorrect use were inadequate inhalation(41.8%, 38/91), inadequate exhalation before inhalation(34.1%, 31/91), and too short breath-holding duration(28.6%, 26/91).The prevalence of incorrect preparation in patients with budesonide and formoterol inhalation was lower than that of those with salmeterol/fluticasone inhalation or tiotropium bromide inhalation(P<0.017). However, these three groups showed no significant difference in the prevalence of errors made in each operation during the inhalation and in mouth washing after inhalation(P>0.05). Binary Logistic analysis showed that education level, prevalence of smoking, and the time spent using the DPI were associated with incorrect use of DPIs(P<0.05). Conclusion: Low education level, smoking and short time spent using the DPI are associated with increased risk of incorrect use of DPIs. To reduce such errors, targeted health education for the patients should be intensified.
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