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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Original Article

An eight-step instruction process for inhalation therapy reveals the need for clear guidance in elderly patients

Kenjiro Furutaa  Takamasa Wadaa  Hiromi Tomiokaa  Gakuji Ishimotob  Shoji Tanakab  Yuho Arakic  Masatoshi Yamazoea  Hirohito Takataa  Yuko Yoshizumia  Masahiro Kanekoa 

aDepartment of Respiratory Medicine, Kobe City Hospital Organization Kobe City Medical Center West Hospital
bDepartment of Pharmacy, Kobe City Hospital Organization Kobe City Medical Center West Hospital
cNursing Department, Kobe City Hospital Organization Kobe City Medical Center West Hospital

ABSTRACT

Inhalation therapy plays a crucial role in the treatment of bronchial asthma and chronic obstructive pulmonary disease. It is therefore important to choose the best inhaler device for individual patients and to provide precise instructions on its usage. This study assessed an eight-step instruction process for inhalation therapy (preparation of the drug, expiration before inhalation, inhalation, breath-holding after inhalation, expiration after breath-holding, cleaning up, gargling after inhalation, and checking the amount remaining) in the outpatient department of Kobe City Medical Center West Hospital. A total of 214 patients were instructed over the course of one year with good results. However, in patients aged ≥75 years, significantly more cases of insufficient understanding were observed for the steps of inhalation (p<0.001), breath-holding after inhalation (p=0.028), gargling after inhalation (p=0.019), and checking the amount remaining (p=0.015). Moreover, in patients using a pressurized metered-dose inhaler, half of the cases required re-instruction. Patients receiving inhalation therapy, especially elderly patients, should be instructed in the inhalation technique as well as in breath-holding and gargling after inhalation.

KEYWORDS

Instruction of inhalation  Bronchial asthma  Chronic obstructive pulmonary disease (COPD)  Pressurized metered-dose inhaler  Dry powder inhaler 

Received 25 Sep 2017 / Accepted 26 Feb 2018

AJRS, 7(3): 135-141, 2018

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