Astımlı Çocukların Ailelerinin İnhaler Cihaz Kullanma Tekniklerinin Değerlendirilmesi

Astım tedavisinde inhale yolla kullanılan ilaçlar direkt olarak solunum yollarına ulaşır, lokal olarak daha yüksek konsantrasyon oluşturur ve sistemik yan etki oluşturma riski diğer yollarla kullanılan ilaçlara nazaran belirgin olarak daha düşüktür. Astımlı çocuk hastaların takip ve tedavi süreci erişkin hastalardan pek çok yönden farklıdır. Çocuk hastalar inhalasyon tekniği ile ilişkili zorlukları yetişkinlerden daha sık yaşamaktadırlar. Yanlış inhaler cihaz kullanma tekniği hastalık kontrolünün sağlanamamasına, alevlenme riskinde artışa ve ilaç yan etkilerinin artmasına neden olur. İnhalasyon tekniğinin düzeltilmesinin hastalık kontrolünün sağlanması, acil servis başvurularının azaltılması, semptomların seyrekleşmesi ve okul devamsızlığının azalması ile ilişkili olduğu bilinmektedir.

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  • 1. Goldberg M, Doughty D, Lawrence K. GINA main report. 2017.
  • 2. Türk Toraks Derneği Astım Tanı ve Tedavi Rehberi. Turkish Thorac J. 2016;17.
  • 3. Ingelheim AB. GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION APPENDİX. 2017. www.ginaasthma.org.
  • 4. Brown PH, Greening AP, Crompton GK. Large volume spacer devices and the influence of high dose beclomethasone dipropionate on hypothalamo-pituitary-adrenal axis function. Thorax. 1993;48(3):233-238. http://www.ncbi.nlm.nih.gov/pubmed/8497821.
  • 5. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest. 2005;127(1):335-371. doi:10.1378/chest.127.1.335.
  • 6. Cates CJ, Welsh EJ, Rowe BH. Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma. Cochrane database Syst Rev. 2013;(9):CD000052. doi:10.1002/14651858.CD000052.pub3.
  • 7. Melani AS, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-938. doi:10.1016/j.rmed.2011.01.005.
  • 8. Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005;50(10):1360-74-5. http://www.ncbi.nlm.nih.gov/pubmed/16185371.
  • 9. Sleath B, Ayala GX, Gillette C, et al. Provider Demonstration and Assessment of Child Device Technique During Pediatric Asthma Visits. Pediatrics. 2011;127(4):642-648. doi:10.1542/peds.2010-1206.
  • 10. Wanda Hagmolen of ten Have, van de Berg NJ, Bindels PJE, van Aalderen WMC, van der Palen J. Assessment of Inhalation Technique in Children in General Practice: Increased Risk of Incorrect Performance with New Device. J Asthma. 2008;45(1):67-71. doi:10.1080/02770900701815834.
  • 11. Capanoglu M, Dibek Misirlioglu E, Toyran M, Civelek E, Kocabas CN. Evaluation of inhaler technique, adherence to therapy and their effect on disease control among children with asthma using metered dose or dry powder inhalers. J Asthma. 2015;52(8):838-845. doi:10.3109/02770903.2015.1028075.
  • 12. Gillette C, Rockich-Winston N, Kuhn JA, Flesher S, Shepherd M. Inhaler Technique in Children With Asthma: A Systematic Review. Acad Pediatr. 2016;16(7):605-615. doi:10.1016/j.acap.2016.04.006.
  • 13. Smith C, Goldman RD. Nebulizers versus pressurized metered-dose inhalers in preschool children with wheezing. Can Fam Physician. 2012;58(5):528-530. http://www.ncbi.nlm.nih.gov/pubmed/22734168.
  • 14. Lin YZ, Hsieh KH. Metered dose inhaler and nebuliser in acute asthma. Arch Dis Child. 1995;72(3):214-218. http://www.ncbi.nlm.nih.gov/pubmed/7741566.
  • 15. Leversha AM, Campanella SG, Aickin RP, Asher MI. Costs and effectiveness of spacer versus nebulizer in young children with moderate and severe acute asthma. J Pediatr. 2000;136(4):497-502. http://www.ncbi.nlm.nih.gov/pubmed/10753248.
  • 16. Ploin D, Chapuis FR, Stamm D, et al. High-dose albuterol by metered-dose inhaler plus a spacer device versus nebulization in preschool children with recurrent wheezing: A double-blind, randomized equivalence trial. Pediatrics. 2000;106(2 Pt 1):311-317. http://www.ncbi.nlm.nih.gov/pubmed/10920157.
  • 17. Bender B, Milgrom H, Rand C. Nonadherence in asthmatic patients: is there a solution to the problem? Ann Allergy Asthma Immunol. 1997;79(3):177-85-6. doi:10.1016/S1081-1206(10)63001-3.
  • 18. Bosnic-Anticevich SZ, Sinha H, So S, Reddel HK. Metered-dose inhaler technique: the effect of two educational interventions delivered in community pharmacy over time. J Asthma. 2010;47(3):251-256. doi:10.3109/02770900903580843.
  • 19. Kamps AWA, Brand PLP, Roorda RJ. Determinants of correct inhalation technique in children attending a hospital-based asthma clinic. Acta Paediatr. 2002;91(2):159-163. http://www.ncbi.nlm.nih.gov/pubmed/11952002.