Use of a Remote Inhaler Monitoring Device to Measure Change in Inhaler Use with Chronic Obstructive Pulmonary Disease Exacerbations
Use of a Remote Inhaler Monitoring Device to Measure Change in Inhaler Use with Chronic Obstructive Pulmonary Disease Exacerbations
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DOI：
10.1089/jamp.2017.1383
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发表时间：
2018-06-01
影响因子：
3.4
通讯作者：
Fan, Vincent S.
中科院分区：
文献类型：
--
作者：
Sumino, Kaharu;Locke, Emily R.;Fan, Vincent S.
背景：远程吸入器监测是一项新兴技术，使医疗团队能够监测患者使用吸入器的时间和地点。我们评估了远程吸入器监测慢性阻塞性肺疾病（COPD）患者的可行性，以及沙丁胺醇吸入器使用与COPD加重相关的模式。方法：35名COPD患者使用电子吸入器传感器12周，记录每次沙丁胺醇驱动的日期和时间。每月评估自我报告的COPD恶化情况和医疗保健利用情况。我们使用带有logit链接的广义估计方程，通过每日沙丁胺醇的使用频率来比较加重日与非加重日的几率。结果：患者在非加重日的平均每日沙丁胺醇使用量差异很大，从1.5到17.5支不等。在研究期间，29名参与者中观察到48次恶化事件，其中16次为中度至重度恶化。在中度至重度恶化期间，与平均非恶化天数相比，平均每日沙丁胺醇使用量的中位数增加了14.1%（四分位数范围：2.7%-56.9%）。吸入器使用增加100%与中度至重度恶化的几率增加相关（优势比1.54;95% CI: 1.21-1.97）。大约74%的参与者对传感器表示满意。结论：在12周的时间里，电子吸入器传感器在老年COPD患者中得到了很好的接受。该装置捕获的沙丁胺醇使用量增加与自我报告的中度至重度恶化发作有关。
Background: Remote inhaler monitoring is an emerging technology that enables the healthcare team to monitor the time and location of a patient's inhaler use. We assessed the feasibility of remote inhaler monitoring for chronic obstructive pulmonary disease (COPD) patients and the pattern of albuterol inhaler use associated with COPD exacerbations. Methods: Thirty-five participants with COPD used an electronic inhaler sensor for 12 weeks which recorded the date and time of each albuterol actuation. Self-reported COPD exacerbations and healthcare utilization were assessed monthly. We used generalized estimating equations with a logit link to compare the odds of an exacerbation day to a nonexacerbation day by the frequency of daily albuterol use. Results: Average daily albuterol use on nonexacerbation days varied greatly between patients, ranging from 1.5 to 17.5 puffs. There were 48 exacerbation events observed in 29 participants during the study period, of which 16 were moderate-to-severe exacerbations. During the moderate-to-severe exacerbation days, the median value in average daily albuterol use increased by 14.1% (interquartile range: 2.7%-56.9%) compared to average nonexacerbation days. A 100% increase in inhaler use was associated with increased odds of a moderate-to severe exacerbation (odds ratio 1.54; 95% CI: 1.21-1.97). Approximately 74% of participants reported satisfaction with the sensor. Conclusions: The electronic inhaler sensor was well received in older patients with COPD over a 12-week period. Increased albuterol use captured by the device was associated with self-reported episodes of moderate-to-severe exacerbations.