일차진료의에서의 흡입기구 사용 숙련도 현황
Assessment of Techniques for Using Inhalers in Primary Care Physicians
0
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
Background: For the optimal asthma management, healthcare professionals (HCPs) should properly educate patients in skills in using inhalers. Objective: To evaluate the skillfulness of primary care physicians (PCPs) in the use of inhalers (pressurized metered dose inhaler [pMDI], turbuhaler and diskus) commonly used for asthma treatment. Method: We evaluated a total of 133 PCPs who attended the instruction program for their techniques for using 3different inhaler devices. Participants completed each step for using inhalers and overall performance was classified as good, adequate and inadequate. The current educations in the use of inhalers to their patients were also assessed. Result: The overall performance was inadequate in 64.7%of the patients using a pMDI, 79.7% of the patients using a turbuhaler and 52.6% of the patients using a diskus. However, 91 PCPs (68.4%) reported that they educated their patients in inhaler techniques. Three and more exposures to the course training in using inhalers were significantly associated with appropriate inhaler techniques in turbuhaler (P=0.018) and diskus (P=0.0002). Conclusion: The skillfulness of PCPs in the use of inhalers was not enough to educate asthmatics. Therefore it is mandatory to develop and implement the effective instruction programs for HCPs in the primary care field.
Abstract
Background: For the optimal asthma management, healthcare professionals (HCPs) should properly educate patients in skills in using inhalers. Objective: To evaluate the skillfulness of primary care physicians (PCPs) in the use of inhalers (pressurized metered dose inhaler [pMDI], turbuhaler and diskus) commonly used for asthma treatment. Method: We evaluated a total of 133 PCPs who attended the instruction program for their techniques for using 3different inhaler devices. Participants completed each step for using inhalers and overall performance was classified as good, adequate and inadequate. The current educations in the use of inhalers to their patients were also assessed. Result: The overall performance was inadequate in 64.7%of the patients using a pMDI, 79.7% of the patients using a turbuhaler and 52.6% of the patients using a diskus. However, 91 PCPs (68.4%) reported that they educated their patients in inhaler techniques. Three and more exposures to the course training in using inhalers were significantly associated with appropriate inhaler techniques in turbuhaler (P=0.018) and diskus (P=0.0002). Conclusion: The skillfulness of PCPs in the use of inhalers was not enough to educate asthmatics. Therefore it is mandatory to develop and implement the effective instruction programs for HCPs in the primary care field.
참고문헌 (23)
- Global initiative for Asthma: global strategy for asthma management and prevention, , National Institutes of Health (US), 110~, pp.NIH Publication No. 02-3659 (2003)
- National Heart, Lung, and Blood Institute: Expert Panel Report: Guidelines for Management of Asthma, , National Institutes of Health (US), 153~, pp.NIH Publication No. 02-5074 (2002)
- 김도진, "천식", Tuberculosis and Respiratory Diseases, 67(2), pp.83~87 (2009), 대한결핵및호흡기학회
- Calverley PM, "Chronic obstructive pulmonary disease", Lancet, 362, pp.1053~1061 (2003)
- Virchow JC, "Importance of inhaler devices in the management of airway disease", Respir Med, 102, pp.10~19 (2008)
- Rau JL, "Practical problems with aerosol therapy in COPD", Respir Care, 51, pp.158~172 (2006)
- "Proceedings of the British Thoracic Society", Thorax, 37, pp.778~792 (1982)
- Guidry GG, "Incorrect use of metered dose inhalers by medical personnel", Chest, 101, pp.31~33 (1992)
- Tsang KW, "Inability of physicians to use metered-dose inhalers", J Asthma, 34, pp.493~498 (1997)
- Self TH, "Inadequate skill of healthcare professionals in using asthma inhalation devices", J Asthma, 44, pp.593~598 (2007)
- Giraud V, "Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability", Eur Respir J, 19, pp.246~251 (2002)
- Melani AS, "Inhalatory therapy training: a priority challenge for the physician", Acta Biomed, 78, pp.233~245 (2007)
- Plaza V, "Medical personnel and patient skill in the use of metered dose inhalers: a multicentric study. CESEA Group", Respiration, 65, pp.195~198 (1998)
- Chopra N, "Does introduction of new "easy to use" inhalational devices improve medical personnel's knowledge of their proper use", Ann Allergy Asthma Immunol, 88, pp.395~400 (2002)
- Self TH, "Does it really matter what volume to exhale before using asthma inhalation devices", J Asthma, 46, pp.212~216 (2009)
- Rebuck D, "The effect of structured versus conventional inhaler education in medical housestaff", J Asthma, 33, pp.385~393 (1996)
- Kim SH, "Inappropriate Techniques Used by Internal Medicine Residents with Three Kinds of Inhalers (a Metered Dose Inhaler, Diskus, and Turbuhaler): Changes after a Single Teaching Session", JOURNAL OF ASTHMA, 46(9), pp.944~950 (2009), MARCEL DEKKER INC
- Chafin CC, "Effect of a brief educational intervention on medical students' use of asthma devices", J Asthma, 37, pp.585~88 (2000)
- Sestini P, "Prescription bias and factors associated with improper use of inhalers", J Aerosol Med, 19, pp.127~136 (2006)
- Lee-Wong M, "Results of a programme to improve house staff use of metered dose inhalers and spacers", Postgrad Med J, 79, pp.221~225 (2003)
- 이의경, "서울 지역 내과 개원의 천식 진료 양상", Tuberculosis and Respiratory Diseases, 55(2), pp.165~174 (2003), 대한결핵및호흡기학회
- Fink JB, "Problems with inhaler use: a call for improved clinician and patient education", Respir Care, 50, pp.1360~1374 (2005)
- Rankin SH, "Educational theories for teaching and motivating patients, In Patient education: issues, principles, practices. 3rd ed", pp.99~120 (1996), Lippincott Williams & Wilkins