吸气峰流速测定在COPD患者吸入装置操作教育中的意义

Significance of Peak Inspiratory Flow Rate in COPD Patients for Clinical Practice of Individualized and Detailed Inhalation Medication Education

目的 探索吸气峰流速(PIFR)测定在慢性阻塞性肺疾病(COPD)患者吸入装置操作和吸入能力教育中的作用。方法 选取2021年6月1日—2021年12月1日在COPD医药联合门诊就诊患者58例,每例患者均多次进行易纳器和气雾剂的PIFR测定。用药教育前测定PIFR1次,用药教育后测定PIFR≥3次(选取最佳的3次取平均值作为用药教育后的PIFR)。药师同时综合评估患者的吸入技术(手口协调能力,缓慢深吸气能力),给出吸入装置的选择建议。结果 入组患者使用易纳器时,用药教育前PIFR为(73.97±30.76)L·min^(-1),用药教育后PIFR为(63.47±12.14)L·min^(-1),用药教育将PIFR达标率由62.07%提高到96.55%;入组患者使用气雾剂装置时,用药教育前PIFR为(102.72±27.42)L·min^(-1),用药教育后PIFR为(52.81±18.31)L·min^(-1),用药教育将PIFR达标率由10.34%提高到68.97%。结论 药师通过PIFR测定,对COPD患者进行吸入装置个体化用药教育,可大幅提高患者使用易纳器与气雾剂吸入装置时的PIFR达标率,亦有助于帮助患者选择适宜的吸入装置。

Objective To practice pharmacists'individualized and detailed inhalation medication education for chronic obstructive pulmonary disease(COPD)patients.Methods A multiple disciplinary team outpatient clinic was established in the department of respiratory and critical care medicine,in which a physician and a pharmacist work together on COPD outpatients’therapeutics and long-term management.58 patients were enrolled from Jul.1,2021 to Dec.31,2021.The peak inspiratory flow rate(PIFR)of the Ellipta device and pMDI device was measured simultaneously for each patient.The PIFR was measured once before the medication education,and more than three times after the medication education(select the best 3 PIFR results and take the average as the PIFR after the medication education).The pharmacist evaluates the patient's inhalation technique(hand-mouth coordination ability,stable inhalation time),then gives suggestions for the optimal inhalation device.Results When patients used Ellipta,the PIFR before the medication education was(73.97±30.76)L·min^(-1),and after medication education was(63.47±12.14)L·min^(-1).Medication education increased the PIFR compliance rate from 62.07%to 96.55%,When patients used the pMDI device,the PIFR was(102.72±27.42)L·min^(-1)before medication education,and was(52.81±18.31)L·min^(-1)after the medication education.The medication education increased the PIFR compliance rate from 10.34%to 68.97%.Conclusion Medication education can significantly improve the PIFR compliance rate of patients using Ellipta and pMDI inhalation devices.