| 赵艳敏,于小杰,王娜,等.慢性阻塞性肺疾病病人干粉吸入剂用药指导模式构建、效果及影响吸入剂用药规范性的高危因素分析[J].安徽医药,2023,27(3):630-633. |
| 慢性阻塞性肺疾病病人干粉吸入剂用药指导模式构建、效果及影响吸入剂用药规范性的高危因素分析 |
| Construction and effect of medication guidance model of dry powder inhaler for chronic obstructive pulmonary disease patients and high risk factors influencing the standardization of inhaler medication |
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| DOI：10.3969/j.issn.1009-6469.2023.03.046 |
| 中文关键词: 肺疾病，慢性阻塞性 自我用药 投药，吸入 病人教育(主题) 乌美溴铵维兰特罗 用药规范性 |
| 英文关键词: Pulmonary disease, chronic obstructive Self medication Administration, inhalation Patient education as topic Umeclidinium bromide and vilanterol trifenatate Standardization of drug use |
| 基金项目:秦皇岛市重点研发计划科技支撑项目(201902A092) |
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| 中文摘要: |
| 目的 研究慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)病人干粉吸入剂用药指导模式构建、效果及影响吸入剂用药规范性的高危因素。方法 采用回顾性研究，以2018年6月至2020年12月秦皇岛市第一医院诊断并进行治疗的98例COPD病人作为研究对象，所有病人均采取乌美溴铵维兰特罗吸入粉雾剂(商品名欧乐欣)进行治疗。按照用药指导的教育模式不同分为观察组(采取Teach-back教育模式进行用药指导)和对照组(常规用药指导)，各49例。评价两组病人的用药规范性、治疗效果之间的差异，分析影响病人的用药规范性的影响因素。结果 观察组病人对于吸入剂药名［45/49(91.84%)比34/45(75.51%)］、调整呼吸方法［48/49(97.96%)比42/49(85.71%)］、用药时间和频率［45/49(91.84%)比35/49(71.43%)］、屏气时间［44/49(89.80%)比36/49(73.47%)］、漱口目的［48/49(97.96%)比40/49(81.63%)］正确率高于对照组(P<0.05)。观察组病人的治疗总有效率高于对照组［45/49(91.84%)比37/49(75.51%)］(P<0.05)。两组病人的年龄［19/69(27.54%)比26/29(89.66%)］、性别［41/69(59.42%)比28/29(96.55%)］、文化程度［40/69(57.97%)比2/29(6.90%)］、月收入［60/69(86.96%)比15/29(51.72%)］、口服用药情况［9/69(13.04%)比12/29(41.38%)］以及病程［35/69(50.72%)比2/29(6.90%)］之间差异有统计学意义(P<0.05)。多因素分析发现，病人的性别、年龄、文化程度、月收入、口服用药情况以及病程均为病人不规范用药的独立影响因素(P<0.05)。结论 慢性阻塞性肺疾病病人干粉吸入剂用药指导采用Teach-back模式，病人的治疗效果显著。年龄较大、男性病人、文化程度较低、家庭收入较低、病程较长、口服用药较多是影响用药规范性的高危因素。 |
| 英文摘要: |
| Objective To study the construction and effect of medication guidance mode of dry powder inhaler for chronic obstruc?tive pulmonary disease (COPD) patients and the high risk factors affecting the standardization of inhaler medication.Methods In this retrospective study, 98 patients with COPD diagnosed and treated in Qinhuangdao First Hospital from June 2018 to December 2020 were selected as the research objects. All patients were treated with umeclidinium and vilanterol(brand name: Anoro Ellipta) for inhala?tion. According to different educational models of medication guidance, they were assigned into the observation group (Teach-back edu?cation mode for medication guidance, n=49) and the control group (conventional medication guidance, n=49), and the differences be?tween the two groups in medication standardization and treatment effect were evaluated to analyze the influencing factors of medication standardization.Results Patients in the observation group had significantly higher accuracy rates for inhalant drug name [45/49(91.84%) vs. 34/45 (75.51%)], breathing adjustment method [48/49 (97.96%) vs. 42/49 (85.71%)], medication duration and frequency[45/49 (91.84%) vs. 35/49 (71.43%)], breath-holding time [44/49 (89.80%) vs. 36/49 (73.47%)] and gargling purpose [48/49 (97.96%)vs. 40/49 (81.63%)] than the control group (P<0.05). The overall effective rate of treatment in observation group was higher than that in control group [45/49 (91.84%) vs. 37/49 (75.51%)] (P<0.05). There were significantly statistical differences in age [19/69 (27.54%) vs.26/29 (89.66%)], gender [41/69 (59.42%) vs. 28/29 (96.55%)], education [40/69 (57.97%) vs. 2/29 (6.90%)], monthly income [60/69(86.96%) vs. 15/29 (51.72%)], use of oral medication [9/69 (13.04%) vs. 12/29 (41.38%)] and course of disease [35/69 (50.72%) vs. 2/29(6.90%)] between the two groups (P<0.05). Multivariate analysis results showed that gender, age, educational, monthly income, use of oral medication and course of disease were independent influencing factors for non-standard medication (P<0.05).Conclusion The treatment effect of dry powder inhaler in COPD patients was significant by using the Teach-back model. High risk factors for medica?tion standardization include old age, male, low education level, low family income, long course of disease and more oral medications. |
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