Anwendung von Inhalatoren und hierdurch bedingte Symptomkontrolle sowie Verbesserung der Lungenfunktion bei geriatrischen Patienten mit chronisch-obstruktiver Lungenerkrankung
Training improves the handling of inhaler devices and reduces the severity of symptoms in geriatric patients suffering from chronic-obstructive pulmonary disease
von Marie-Christine Anette Luley
Datum der mündl. Prüfung:2022-03-17
Erschienen:2022-03-08
Betreuer:Prof. Dr. Roland Nau
Gutachter:Prof. Dr. Roland Nau
Gutachter:Dr. Achim Rittmeyer
Dateien
Name:Luley_MarieChristine_Dissertation.pdf
Size:5.27Mb
Format:PDF
Zusammenfassung
Englisch
Purpose The use of inhalers requires a high degree of fine motor skills and coordination, which is particularly difficult for elderly patients suffering from chronic-obstructive pulmonary disease (COPD). Many of these patients exhibit physical and cognitive impairments, such as impaired vision or cognitive decline. Accordingly, the number of medication inhalation errors among these patients is high which impedes optimal drug delivery to the bronchioles. This study was designed to offer a video-based training to reduce the number of mistakes in the inhalation process. Methods This prospective intervention study was conducted from October 1, 2016 to September 30, 2017 and included 38 patients older than 65 years suffering from COPD. Patients participated in a video-based training over an 8-day period. Before and after training, the number of mistakes, the perception of symptoms counted by COPD Assessment Test (CAT) and the forced expiratory volume in 1 second (FEV1) were compared by Wilcoxon signed rank test. Results After the training the patients made fewer mistakes (from 3.0 (0-7) to 0.5 (0-6; [median (minimum-maximum; p < 0.0001)]. The CAT Score was reduced from 19.5 (14/24) to 14.5 (10.75/21) [median (25./75. percentile; p < 0.0001)] while the parameters of lung function did not change significantly. Conclusion An intensive 8-day video-based training reduced the number of mistakes geriatric patients with COPD made when using inhalator devices. This also applies to patients with limited cognitive ability.
Keywords: COPD