在选择COPD吸入输送系统时考虑和评估患者因素
Donald A Mahler1, David M G Halpin2
1Geisel School of Medicine at Dartmouth, Hanover, NH; Respiratory Services, Valley Regional Hospital, Claremont, NH.
Chest
|November 17, 2023
概括
选择适合COPD患者的吸入器至关重要. 医疗保健提供者应评估认知功能,手工敏捷性和灵感流,以确保有效的药物治疗.
科学领域:
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
- 医疗器械 医疗器械
背景情况:
- 目前的COPD药理治疗指南侧重于吸入药物类别,但缺乏针对个体患者选择适当的输送系统的指导.
- 医疗保健专业人员存在一个尚未满足的需求,即将吸入药物输送系统与患者特定特征相匹配.
- 患者的因素,如认知功能,手术技巧/力量,以及最高吸气流,都会对手持吸入器设备的正确使用产生重大影响.
研究的目的:
- 根据患者的关键因素,为选择吸入药物输送系统提供指导.
- 概述用于评估COPD患者认知功能,手工敏捷性/强度和峰值灵感流的具体测试.
- 突出COPD患者中这些因素受损的普遍性及其对吸入治疗有效性的影响.
主要方法:
- 审查现有的文献和关于COPD药物治疗和吸入药物输送系统的指导方针.
- 识别和描述影响吸入器设备选择的关键患者因素:认知功能,手工敏捷/强度和最高吸气流量.
- 讨论评估这些患者因素的方法,包括认知评估和峰值灵感流量测量 (PIFr).
主要成果:
- 认知障碍影响了25%的COPD患者,影响了他们正确使用手持设备的能力.
- 79%的COPD患者报告了可能影响吸入器操纵的身体障碍; 精度/力量受损的流行情况没有得到充分报告.
- 在19%至84%的COPD稳定门诊患者中报告了低于最佳的峰值吸气流 (PIFr),影响了干粉吸入器的有效性.
结论:
- 认知功能,手工敏捷/强度和PIFr是医疗保健专业人员在为COPD处方吸入药物治疗时需要考虑的关键因素.
- 这些患者因子的损伤在COPD中很常见,并且可以显著影响吸入药物使用的能力和有效性.
- 根据患者特异性评估,个性化选择吸入器设备对于优化COPD管理至关重要.
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