"General Practitioner-Specialist" Model in Mastering Inhalation Skills for Patients with Asthma

doi:10.12114/j.issn.1007-9572.2019.00.388

Abstract

Abstract: Background　Asthma is a key component of community chronic disease management.The Global Initiative for Asthma（GINA） noted that inhaled corticosteroids are currently one of the most effective treatments for asthma.However，most patients with asthma can not receive good therapeutic effect due to poor inhalation skills.Objective　To explore the application value of "General practitioner-specialist" model in mastering inhalation skills for patients with asthma.Methods　A total of 180 patients with asthma who were admitted to the department of respiratory in Shanghai Changhai Hospital were included in the study from January to December 2018.They were randomly divided into control group and test group，each with 90 cases.All patients were treated with inhaler of budesonide formoterol inhalation powder.The control group was given conventional guidance methods to guide how to master inhalation skills and the test group used "General practitioner-specialist" mode.The error in using the inhaled drug（inhalation method error and device operation error） and the correct inhalation skills（correct device operation，inhalation method as inhalation skills） would be recorded after each guidance.Results　After the second，third instruction，the error rate of inhalation method in the test group was lower than that in the control group（P<0.05）．The operation error rate of patients in the test group after the second and third instructions was lower than that in the control group（P<0.05）．In the control group，the correct rate of inhalation skills after the second instruction was higher than that after the first instruction（P=0.010）；the correct rate of inhalation skills after the third instruction in the control group was higher than that after the second instruction（P=0.003）．The correct rate of inhalation skills after the second instruction in the test group was higher than that after the first instruction（χ2=27.388，P<0.001）；the correct rate of inhalation skills after the third instruction in the test group was higher than that after the second instruction（χ2=11.262，P=0.001）．The correct rate of inhalation skills in the test group was higher than that in the control group after the second，third，forth instructions（χ2=9.454，P=0.003；χ2=11.262，P=0.001；χ2=5.178，P=0.039）．Conclusion　“General practitioner-specialist” model not only has good effect and high efficiency，but also can effectively improve the mastery of inhalation skills.

Key words: Asthma；Administration, inhalation；Insufflation；Chronic disease；General practitioner-specialist；Shanghai

摘要： 背景　支气管哮喘（哮喘）是社区慢性病管理的重点内容。全球哮喘防治创议（GINA）指出吸入糖皮质激素是目前控制哮喘最有效的治疗方法之一。但多数哮喘患者由于掌握不好吸入技术而影响治疗效果。目的　探讨“全-专结合”模式对指导哮喘患者掌握吸入技术的应用价值。方法　选取2018年1—12月在上海长海医院呼吸内科门诊就诊的哮喘患者180例，根据随机数字表法将患者分为对照组90例和试验组90例。两组患者均给予布地奈德福莫特罗粉吸入剂喷服，对照组采用常规指导方法指导吸入技术，试验组采用“全-专结合”模式指导吸入技术。记录患者在使用吸入药物中发生错误的情况（吸入方法错误或装置操作错误）及吸入技术正确情况（装置操作、吸入方法均正确判定为吸入技术正确）。结果　第2、3次指导后试验组患者吸入方法错误率低于对照组（P<0.05）；第2、3次指导后试验组患者装置操作错误率低于对照组（P<0.05）。对照组第2次指导后吸入技术正确率高于第1次指导后（P=0.010）；对照组第3次指导后吸入技术正确率高于第2次指导后（P=0.003）。试验组第2次指导后吸入技术正确率高于第1次指导后（χ2=27.388，P<0.001）；试验组第3次指导后吸入技术正确率高于第2次指导后（χ2=11.262，P=0.001）。试验组患者第2、3、4次指导后吸入技术正确率均高于对照组（χ2=9.454，P=0.003；χ2=11.262，P=0.001；χ2=5.178，P=0.039）。结论　“全-专结合”模式指导吸入技术效果好、效率高，而且能有效提高患者对吸入技术的掌握程度。

关键词: 哮喘, 投药、吸入, 吸入法, 慢性病, 全-专结合, 上海市

ZHAO Jiayi,ZHANG Rong,LI Xia, et al. "General Practitioner-Specialist" Model in Mastering Inhalation Skills for Patients with Asthma　[J]. Chinese General Practice, 2019, 22(28): 3451-3454. DOI: 10.12114/j.issn.1007-9572.2019.00.388.
赵家义,张蓉,李夏等. “全-专结合”模式指导哮喘患者掌握吸入技术的应用价值[J]. 中国全科医学, 2019, 22(28): 3451-3454. DOI: 10.12114/j.issn.1007-9572.2019.00.388.

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