Misuse of inhalers among COPD patients in a community hospital in Taiwan

Autor: Yi-Jen Chen, Ching-Fang Tsai, Shew-Meei Sheu, Chi-Yen Liang, Wei Chen
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Health Knowledge
Attitudes
Practice

Respimat
Cross-sectional study
Taiwan
Inhalation Spacers
Hospitals
Community

International Journal of Chronic Obstructive Pulmonary Disease
misuse
inhaler
chronic obstructive pulmonary disease
03 medical and health sciences
Pulmonary Disease
Chronic Obstructive

0302 clinical medicine
Drug Delivery Systems
Patient Education as Topic
Risk Factors
Administration
Inhalation

Odds Ratio
Medicine
Humans
030212 general & internal medicine
Metered Dose Inhalers
Lung
Original Research
Aged
Aged
80 and over

COPD
Chi-Square Distribution
business.industry
Inhaler
General Medicine
Odds ratio
Equipment Design
Middle Aged
medicine.disease
Community hospital
Bronchodilator Agents
Self Care
Cross-Sectional Studies
Logistic Models
030228 respiratory system
Emergency medicine
Female
business
Chi-squared distribution
Zdroj: International Journal of Chronic Obstructive Pulmonary Disease
ISSN: 1178-2005
1176-9106
Popis: Chi-Yen Liang,1 Yi-Jen Chen,1 Shew-Meei Sheu,2 Ching-Fang Tsai,2 Wei Chen1 1Division of Pulmonary and Critical Care Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan; 2Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan Purpose: Respiratory inhalers, which directly deliver medication to the airway, are important for controlling symptoms and preventing exacerbations of chronic obstructive pulmonary disease (COPD). The inhaler misuse rate of patients with COPD in Taiwan is unclear. In this study, the inhaler techniques and patient characteristics associated with incorrect inhaler techniques among patients with COPD were evaluated. Patients and methods: This cross-sectional study enrolled 298 patients with COPD (mean age 72.10 years) who used at least one inhaler device. The following five types of inhalers were included: metered-dose inhaler (MDI) with spacer, Diskus®, Turbuhaler®, Respimat®, and Breezhaler®. The inhaler technique was evaluated step by step. Misuse of an individual inhaler was defined as an error in at least one step. The sociodemographic characteristics, vision, hearing ability, type and number of inhalers, and inhaler-related knowledge of these patients were recorded. Results: The misuse rates of the five types of inhalers ranged from 65.00% to 87.89%. The Respimat inhaler was the most likely to be assembled incorrectly. The steps that were most commonly performed incorrectly were “breathing out fully” and “holding breath”. In the logistic regression analysis, poor hearing was related to misuse of the MDI with spacer (adjusted odds ratio [aOR] 9.85; 95% CI 1.40–69.30); the number of acute exacerbations was related to misuse of Breezhaler (aOR 4.07; 95% CI 1.50–11.08). Incorrect inhaler-related knowledge was significantly associated with misuse in handling the MDI with spacer (aOR 9.58; 95% CI 2.14–42.80), Respimat (aOR 5.14; 95% CI 2.07–12.76), and Breezhaler (aOR 6.98; 95% CI 1.95–25.08). Conclusion: The misuse rates were high for all five types of inhaler. Poor hearing and the number of acute exacerbations were device-specific factors related to the misuse of inhalers. Inhaler-related knowledge was significantly associated with misuse, emphasizing the importance of inhaler education. Keywords: misuse, inhaler, chronic obstructive pulmonary disease
Databáze: OpenAIRE