351 KB30 KB355 KB29 KB192920262017Košnik, MitjaŠelb, Julij GyulaTriller, Nadjaštevilka:3/4letnik:86str. 105-114ISSN:1318-0347COBISSID:291153152URN:URN:NBN:SI:doc-J7HENUCTslSlovensko zdravniško društvoZdravniški vestnikasthmaastmabolezni dihalCOPDdisease exacerbationgeneric substitutiongenerična substitucijahealth educationKOPBkronična obstruktivna pljučna bolezenposlabšanje boleznizdravstvena vzgojaMnenje pulmologov o pomenu vdihovalnikov pri bolnikih z astmo ali KOPB| Opinion of pneumologists on the importance of inhalers in patients with asthma or COPD|Background: Medications for asthma and COPD are mainly used in the form of inhalations. A survey was performed to obtain the opinion of experts about the importance of inhalers in inhaled drug therapy. Methods: All members-pulmonologists of the Slovenian Respiratory Society were invited to participate in the survey using a two-stage Delphi method. The result of each response were shown by the median and interquartile range, whereby we calculated the level of consensus. Results: 176 doctors were invited. Most questions were answered by 49 (27.8 %) participants. In the second round 42 doctors responded. As many as 33 out of 41 respondents (80.5 %) felt that in the treatment of asthma and COPD the selection of medicines and inhalers are equally important. When choosing an inhaler, it is crucial that it is simple to instruct the patients about its use. Respondents highly agreed with the statement that patients should receive a prescription for inhaler only after they have been trained on how to use it. As appropriate persons for the training of patients on the use of inhalers the respondents recognized (from most to least suitable) pulmonologists, nurses, general practitioners or pharmacists. 53.8 % of respondents considered that the patient's skill of the use of inhaler should be checked on every visit to the doctor. Respondents believed that replacing inhalers without consulting the treating doctor may result in incorrect use of the inhaler, poor patient compliance, more exacerbations of the disease and poorer disease control. Some consensus with an indifferent median of 4.5 was reached with regard to the argument that the doctor should prescribe the inhaler that is the cheapest for society. Conclusions: Slovenian pulmonologists believe that any change of inhaler is a critical event, which must be coordinated with the patient and the doctorIzhodišče: Zdravila za astmo in KOPB se v glavnem uporabljajo v obliki inhalacij. Raziskavo smo naredili z namenom, da pridobimo mnenje izvedencev o tem, koliko je pri zdravljenju z vdihanim zdravilom pomemben vdihovalnik. Metode: K sodelovanju v anketi po načelih dvostopenjske delfske metode smo povabili vse člane Združenja pulmologov Slovenije. Rezultat vsakega odgovora smo prikazali z mediano in interkvartilnim območjem, s pomočjo katerih smo nato izrazili stopnje konsenza. Rezultati: H glasovanju je bilo povabljenih 176 zdravnikov. Na večino vprašanj jih je odgovorilo 49 (27,8 %). V drugem krogu je sodelovalo 42 oseb. Kar 33 od 41 anketirancev (80,5 %) je menilo, da je pri zdravljenju astme ali KOPB enako pomemben izbor zdravila in vdihovalnika. Pri izbiri vdihovalnika se anketirancem zdi pomembno, da je možno bolnika enostavno poučiti o načinu njegove uporabe. Anketiranci so se zelo strinjali s trditvijo, da bi bolnik prejel recept za vdihovalnik šele potem, ko bi ga strokovnjak usposobil za njegovo uporabo. Kot ustrezne osebe za usposabljanje bolnika o uporabi vdihovalnika se anketirancem zdijo (od najbolj do najmanj primerne) pulmolog, medicinska sestra, osebni zdravnik in farmacevt. 53,8 % anketirancev je menila, da bi se preverjanja bolnikovega znanja o uporabi vdihovalnika moralo izvajati ob vsakem obisku pri zdravniku. Anketiranci so menili, da bi zamenjava vdihovalnika brez posveta z zdravnikom lahko imela za posledico nepravilno uporabo vdihovalnika, slabo sodelovanje bolnika, več poslabšanj bolezni in slabši nadzor bolezni. Nekaj konsenza z indiferentno mediano 4,5 so anketiranci dosegli glede trditve, da bi zdravnik moral predpisati vdihovalnik, ki je za družbo najcenejši. Zaključki: Slovenski pulmologi menijo, da je morebitna zamenjava vdihovalnika kritičen dogodek, ki mora biti usklajen z bolnikom in zdravnikomTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo