tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.58838/2075-1230-2023-101-3-6-14tiblj-1725Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСопоставление правильности применения ингаляторов разного типа у пациентов с ХОБЛ и бронхиальной астмойComparison of the Correct Use of Different Types of Inhalers in Patients with COPD and Bronchial Asthmahttps://orcid.org/0000-0001-5028-5276ВизельА. А.VizelA. A.

Визель Александр Андреевич, Д.м.н., профессор, заведующий кафедрой фтизиопульмонологии 

Тел.: +7 (987) 296-25-99 

Author ID: 195447  ORCID

420012, г. Казань, ул. Бутлерова, 49

Alexander A. Vizel, Doctor of Medical Sciences, Professor, Head of Phthisiopulmonology Department 

Phone: +7 (987) 296-25-99

Author ID: 195447 

49, Butlerova Street, Kazan, Republic of Tatarstan, 420012

Lordara@inbox.ruРезяповаА. И.RezyapovaA. I.

Резяпова Алина Игоревна,  Аспирант кафедры фтизиопульмонологии

Тел.: +7 (987) 189-64-29 

420012, г. Казань, ул. Бутлерова, 49

 

Alina I. Rezyapova, Post Graduate Student of Phthisiopulmonology Department 

Phone: +7 (987) 189-64-29  49

Butlerova Street, Kazan, Republic of Tatarstan, 420012

rezyapovaai@mail.ruhttps://orcid.org/0000-0002-8855-8177ВизельИ. Ю.VizelI. Yu.

Визель Ирина Юрьевна, Д.м.н., профессор РАЕ,  доцент кафедры фтизиопульмонологии 

Тел.: +7 (917) 903-91-13  

Author ID: 246946 

420012, г. Казань, ул. Бутлерова, 49

Irina Yu. Vizel, Doctor of Medical Sciences, Professor of the Russian Academy  of Natural History, Associate Professor  of Phthisiopulmonology Department 

Phone: +7 (917) 903-91-13 

Author ID: 246946 

49, Butlerova Street, Kazan, Republic of Tatarstan, 420012

ФГБОУ ВО «Казанский государственный медицинский университет» МЗ РФРоссияKazan State Medical UniversityRussian Federation20230107202310136–14Copyright © Визель А.А., Резяпова А.И., Визель И.Ю., 20232023Визель А.А., Резяпова А.И., Визель И.Ю.Vizel A.A., Rezyapova A.I., Vizel I.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1725Цель исследования

Цель исследования: сопоставить правильность применения ингаляторов разного типа у пациентов с ХОБЛ и бронхиальной астмой (БА).

Материалы и методы

Материалы и методы. Было обследовано 100 пациентов с ХОБЛ и 108 пациентов с БА. Оценили 9 устройств: дозирующий аэрозольный ингалятор (ДАИ), Рапихалер, Респимат, Бризхалер, CDM-ингалятор, Турбухалер, Дженуэйр, Спиромакс и Эллипту. Технику применения оценивали до прочтения пациентом инструкции на основании интуиции, после прочтения инструкции к ингалятору и после проведения обучения техники ингаляции врачом-исследователем.

Результаты

Результаты. На интуитивном уровне при ХОБЛ было достигнуто более 30% случаев успешного применения у Эллипты, Бризхалера и Спиромакса. После прочтения инструкции планку в 80% правильной техники ингаляции преодолели CDM-ингалятор, Спиромакс, Дженуэйр и Эллипта. Обучение врачом позволило достичь 100% успеха для Спиромакса, Дженуэйра, Эллипты, Бризхалера и CDM-ингалятора. При БА на интуитивном уровне было достигнуто более 50% случаев успешного применения у Спиромакса, Эллипты, Рапихалера и ДАИ. После прочтения инструкции планку в 80% правильной техники ингаляции преодолели CDM-ингалятор, Спиромакс, Эллипта, CDM-ингалятор, Бризхалер и Дженуэйр. Обучение врачом позволило достичь 100% успеха для Спиромакса, Эллипты, Бризхалера и CDM-ингалятора.

Заключение

Заключение. Ингаляторы значимо различаются по способности пациентов правильно их использовать. Пациенты с БА лучше овладевают техникой ингаляций, чем пациенты с ХОБЛ. Жидкостные ингаляторы были более сложными для достижения правильности ингаляций, а наилучшие результаты были у многодозных порошковых ингаляторов. Решающую роль в достижении правильности использования ингаляторов играет обучение пациента медицинским работником.

The objective

The objective: to compare the correct use of different types of inhalers in patients with COPD and bronchial asthma.

Subjects and Methods

Subjects and Methods. 100 patients with COPD and 108 patients with BA were examined. Nine devices were evaluated – a metered dose inhaler (MDI), Rapihaler, Respimat, Breezhaler, CDM, Turbuhaler, Genuair, Spiromax, and Ellipta. The application technique was assessed before the patient read the use instructions and was governed by his intuition, after reading the use instructions, and after training in the inhalation technique by the investigating physician.

Results

Results. When COPD patients used inhalers by intuition, they managed to use them successfully in more than 30% of cases with Ellipta, Breezhaler, and Spiromax. After reading the use instructions, the correct use was achieved in 80% of cases when using CDM inhaler, Spiromax, Genuair, and Ellipta. Training conducted by the physician resulted in 100% success rate for Spiromax, Genuair, Ellipta, Breezhaler, and CDM inhaler. With asthma patients using inhalers by intuition, the correct use was observed in more than 50% of cases with Spiromax, Ellipta, Rapihaler, and MDI. After reading the instructions, the correct use was achieved in 80% of cases with CDM inhaler, Spiromax, Ellipta, CDM inhaler, Breezhaler, and Genuair. Training conducted by the physician allowed achieving 100% success rate for Spiromax, Ellipta, Breezhaler, and CDM inhaler.

Conclusion

Conclusion. Inhalers vary significantly by the patients’ ability to use them correctly. Asthma patients master the correct inhalation technique better versus COPD patients. Liquid inhalers were more difficult to be used correctly, and the best results were observed with multi-dose powder inhalers. The patient’s training by a healthcare professional is critical to assure the correct use of inhalers.

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The effect of repeated video-training session on metered doseinhaler skills among individuals with COPD: Prospective randomised controlled study // J. Clin. Nurs. 2022. – Vol. 31, № 9–10. – P. 1339– 1347. doi: 10.1111/jocn.15990.Dal Negro R. W., Povero M. A Bayesian framework to assess the usability of dry powder inhalers in a cohort of asthma adolescents in Italy. Children (Basel), 2022, vol. 9, no 1, p. 28. doi: 10.3390/children9010028.Dal Negro R. W., Povero M. A Bayesian framework to assess the usability of dry powder inhalers in a cohort of asthma adolescents in Italy. Children (Basel), 2022, vol. 9, no 1, p. 28. doi: 10.3390/children9010028.Gemicioglu B., Gungordu N., Can G., Alp Yıldırım F. I., Uydeş Doğan B. S. Evaluation of real-life data on the use of inhaler devices, including satisfaction and adherence to treatment, by community pharmacists in partnership with pulmonary disease specialists. J. Asthma, 2022, Dec 1, pp. 1–15. doi: 10.1080/02770903.2022.2144355. Online ahead of print.Gemicioglu B., Gungordu N., Can G., Alp Yıldırım F. I., Uydeş Doğan B. S. Evaluation of real-life data on the use of inhaler devices, including satisfaction and adherence to treatment, by community pharmacists in partnership with pulmonary disease specialists. J. Asthma, 2022, Dec 1, pp. 1–15. doi: 10.1080/02770903.2022.2144355. Online ahead of print.Molimard M., Raherison C., Lignot S., Balestra A., Lamarque S., Chartier A., Droz-Perroteau C., Lassalle R., Moore N., Girodet P. O. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur. Respir. J., 2017, vol. 49, pp. 1601794. doi.org/10.1183/13993003.01794-2016Molimard M., Raherison C., Lignot S., Balestra A., Lamarque S., Chartier A., Droz-Perroteau C., Lassalle R., Moore N., Girodet P. O. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur. Respir. J., 2017, vol. 49, pp. 1601794. doi.org/10.1183/13993003.01794-2016Puah S. H., Goh C. Y., Chan C. L., Teoh A. K. J., Zhang H., Shen Z., Neo L. P. Mobile device: a useful tool to teach inhaler devices to healthcare professionals. BMC Med. Educ., 2022, vol. 22, no 1, p. 238. doi: 10.1186/s12909-022-03302-0.Puah S. H., Goh C. Y., Chan C. L., Teoh A. K. J., Zhang H., Shen Z., Neo L. P. Mobile device: a useful tool to teach inhaler devices to healthcare professionals. BMC Med. Educ., 2022, vol. 22, no 1, p. 238. doi: 10.1186/s12909-022-03302-0.Roche N., Aguilaniu B., Paternotte S., Dallery N. Real-life association between inhaler technique, patient preference and asthma control in patients with uncontrolled asthma switched to budesonide/formoterol DuoResp® Spiromax® combination. J. Asthma, 2022, vol. 59, no 4, pp. 765–774. doi: 10.1080/02770903.2021.1875482.Roche N., Aguilaniu B., Paternotte S., Dallery N. Real-life association between inhaler technique, patient preference and asthma control in patients with uncontrolled asthma switched to budesonide/formoterol DuoResp® Spiromax® combination. J. Asthma, 2022, vol. 59, no 4, pp. 765–774. doi: 10.1080/02770903.2021.1875482.Swart M., Laher A. E. Secondary asthma prevention measures are not adequately addressed prior to emergency department discharge! Am. J. Emerg. Med., 2022, vol. 53, pp. 196–200. doi: 10.1016/j.ajem.2022.01.012.Swart M., Laher A. E. Secondary asthma prevention measures are not adequately addressed prior to emergency department discharge! Am. J. Emerg. Med., 2022, vol. 53, pp. 196–200. doi: 10.1016/j.ajem.2022.01.012.van der Palen J., Slade D., Rehal S., Verma M., Plank M. A randomized, cross-over study comparing critical and overall errors, learning time, and preference of the ELLIPTA versus BREEZHALER dry powder inhalers in patients with asthma. Respir Med., 2022, vol. 205, pp. 107031. doi: 10.1016/j.rmed.2022.107031.van der Palen J., Slade D., Rehal S., Verma M., Plank M. A randomized, cross-over study comparing critical and overall errors, learning time, and preference of the ELLIPTA versus BREEZHALER dry powder inhalers in patients with asthma. Respir Med., 2022, vol. 205, pp. 107031. doi: 10.1016/j.rmed.2022.107031.Y ld z E., Çeçen S., Lafci D., Eker A. The effect of repeated video-training session on metered doseinhaler skills among individuals with COPD: Prospective randomised controlled study. J. Clin. Nurs., 2022, vol. 31, no 9–10, pp. 1339– 1347. doi: 10.1111/jocn.15990.Y ld z E., Çeçen S., Lafci D., Eker A. The effect of repeated video-training session on metered doseinhaler skills among individuals with COPD: Prospective randomised controlled study. J. Clin. Nurs., 2022, vol. 31, no 9–10, pp. 1339– 1347. doi: 10.1111/jocn.15990.

The authors declare that there are no conflicts of interest present.