Establishment and evaluation of a pharmaceutical intervention procedure for chronic pulmonary disease patients with dry powder inhalers
Shi Dongming1, Xu Haofeng1, Yang Huajun1, Du Junwei2, Ye Xiaofen3
1 Department of Pharmacy, the First Hospital of Fuyang District, Hangzhou 3114002, China; 2 Deparment of Respiratory Medicine, the First Hospital of Fuyang District; 3 Department of Pharmacy, Zhongshan Hospital, Fudan University
Abstract：Objective To evaluate the effect of pharmaceutical intervention procedures on the efficacy of dry powder inhalers in patients with chronic pulmonary disease by establishing a standard model.Methods Patients in the intervention group were consecutively intervened for 6 months using the established pharmacological intervention procedure and evaluation criteria. The control group received only routine follow-up. The DPI operating score, lung function index, symptom self-assessment, disease control, drug-related knowledge and number of patients in emergency were evaluated before and after the treatment for the two groups.Results In the intervention group, after 6 months of pharmacological monitoring, the inhalation device operation score and CAT/ACT score of the patients with chronic obstructive pulmonary disease (COPD) were significantly improved compared with the control group (t=3.790, 4.661, P<0.05). The difference was also significant compared with the control group (q=3.108, 2.539, P<0.05). After 6 months of treatment for asthma patients, the inhalation device operation score, FEV1% predicted value, and ACT score of the intervention group were significantly higher than those of the control group (t=4.622, 3.912, 7.418, P<0.05). The difference between the two groups was also significant (q=2.698, 2.089, 2.264, P<0.05). In addition, the number of patients in the intervention group was significantly lower than that that in the control group (χ2=4.85, P<0.05), and the scores of the drug-related knowledge questionnaires were significantly higher than those in the control group (χ2=6.68, P<0.05). The number of people with good adherence was higher than that in the control group (χ2=8.15, P<0.05).Conclusions The establishment of standard medication intervention procedure for inhalants can improve the standardization and effectiveness of inhalation therapy, stabilize disease progression, and have good practical and scientific value in disease management and treatment.
史东明, 徐浩锋, 杨华俊, 堵钧伟, 叶晓芬. 干粉吸入剂药学干预流程的建立及疗效评价分析[J]. 中国医院统计, 2018, 25(6): 437-440.
Shi Dongming, Xu Haofeng, Yang Huajun, Du Junwei, Ye Xiaofen. Establishment and evaluation of a pharmaceutical intervention procedure for chronic pulmonary disease patients with dry powder inhalers. journal1, 2018, 25(6): 437-440.
[1] 中华医学会呼吸疾病分会慢阻肺学.慢性阻塞性肺疾病诊治指南:2013年修订版[J].中华结核与呼吸杂志,2013,36(4):255-265. [2] LONGEST PW, TIAN G, WALENGA RL,et al. Comparing MDI and DPI aerosol deposition using in vitro experiments and a new stochastic individual path (SIP) model of the conducting airway[J].Pharm Res, 2012,29(6):1670-1688. [3] GOLD Executive Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: Revised 2017[EB/OL]. http://www.goldcopd.com. [4] Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention: Revised 2018[EB/OL].http://ginasthma.org. [5] 陈素卿,金美玲.慢性气道疾病患者使用干粉吸入剂的用药调查及药学监护[J].中国临床药学杂志,2008,17(3):162-165. [6] 姚莉,胡兰.对影响慢性气道疾病住院患者规范使用干粉吸入剂因素的分析[J].医药导报,2016,35(11):1272-1275. [7] ROBERT B, ANGELA P, Alaina B.Inhaler device selection: Special considerations in elderly patients with chronic obstructive pulmonary disease[J].Am J Health-Syst Pharm ,2011, 68 (13): 1221-1232. [8] MASAYA T, KATSUMI M, MASAKO I, et al. Impact of a network system for providing proper inhalation technique by community pharmacists[J]. J Asthma,2012,49 (5):535-541. [9] BEREZNICKI BJ, PETERSON G, JACKSON S, et al. Uptake and effectiveness of a community pharmacy intervention programme to improve asthma management.[J]. Journal of Clinical Pharmacy & Therapeutics, 2013, 38(3):212-218. [10]ZHONG H,NI XJ,CUI M,et al. Evaluation of pharmacist care for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis[J]. Int J Clin Pharm, 2014,36 (6) :1230-1240. [11]GIRAUD V, ALLAERT FA, ROCHE N. Inhaler technique and asthma: Feasability and acceptability of training by pharmacists[J]. Respir Med, 2011,105(12):1815-1822. [12]胡巍,张桂凡,吴秋惠,等.国外药师参与肺吸入制剂治疗管理的工作模式探讨[J].中国医院药学杂志,2017,37(15):1421-1425.
