Construction of the rating scale for key techniques using the inhaler device for patients with chronic airway disorder based on the Delphi-AHP method_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LIU Xiangmin ¹ , WU Ying ¹ , YANG Cui ¹ , AO Dongmei ¹ , WANG Feng ¹ , XU Yiran ¹ , ZHANG Xuan ³ , ZHU Jing ¹ ,  FENG Mei ^1,2

1. Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University /West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, P.R. China;
2. Nursing Key Laboratory of Sichuan Province, Chengdu, Sichuan, 610041, P.R. China;
3. Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China;

Corresponding author：

FENG Mei, Email: fm197711@163.com

Keywords：

Chronic airway disorder; Inhaler device; Key technique; Assessment tool

DOI：

10.7507/1671-6205.202408010

Video：

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Objective we want to construct a rating scale for the key technique using the inhaler device for patients with chronic airway disorder and to provide a reference tool for the scientific evaluation of patients’ techniques in the use of inhaler devices. Methods Through literature review and Delphi expert consultation, the items of the rating scale were determined, and the weights and assignments of the items were determined through the analytic hierarchy process. The resulting evaluation form was used for clinical assessment of patients, and the differentiation of each item was tested by the critical ratio method.Results After the two rounds of consultation, the positive coefficients of experts were 95.24% and 100%, the expert authority coefficients were 0.988 and 0.990, and the Kendall-W coefficients were 0.371 (P<0.001) and 0.654 (P<0.001), respectively. The final form, consisting of 10 operational items for evaluating key inhaler techniques for patients with chronic airway disorder, was finalized. The results of the hierarchical analysis showed that the consistency ratio CR was 0.088<0.10, which satisfied the consistency test. The top 5 key operational steps were medication preparation, exhalation, holding the mouthpiece, inhalation, and breathholding. Used for clinical patient assessment showed better discrimination of items (t ≥ 3, P<0.05).Conclusion The rating scale for the technique using the inhaler device for chronic airway disorder constructed in this study is scientifically reliable, convenient, and practical, which can be used as an objective evaluation tool to assess patients’ skill in inhaler device use.

Citation： LIU Xiangmin, WU Ying, YANG Cui, AO Dongmei, WANG Feng, XU Yiran, ZHANG Xuan, ZHU Jing, FENG Mei. Construction of the rating scale for key techniques using the inhaler device for patients with chronic airway disorder based on the Delphi-AHP method. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(10): 685-690. doi: 10.7507/1671-6205.202408010 Copy

1.	中国医学装备协会呼吸病学专委会吸入治疗与呼吸康复学组. 稳定期慢性气道疾病吸入装置规范应用中国专家共识(2023版). 中华结核和呼吸杂志, 2023, 46(11): 1055-1067.
2.	中国医学装备协会呼吸病学专委会吸入治疗与呼吸康复学组, 中国慢性阻塞性肺疾病联盟. 稳定期慢性气道疾病吸入装置规范应用中国专家共识. 中华结核和呼吸杂志, 2019, 42(4): 241-253.
3.	赵茜, 钮美娥, 吴振云. 呼吸系统疾病患者正确掌握药物吸入技术的研究进展. 中华护理杂志, 2021, 56(9): 1426-1431.
4.	Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res, 2018, 19(1): 10.
5.	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.
6.	Lewis A, Torvinen S, Dekhuijzen PN, et al. The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries. BMC Health Serv Res, 2016, 16: 251.
7.	黄浠婷, 骆晓琳, 王净, 等. 慢性阻塞性肺疾病患者吸入用药管理的证据总结. 中国护理管理, 2023, 23(11): 1720-1726.
8.	Hämmerlein A, Müller U, Schulz M. Pharmacist-led intervention study to improve inhalation technique in asthma and COPD patients. J Eval Clin Pract, 2011, 17(1): 61-70.
9.	Chrystyn H, Price DB, Molimard M, et al. Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study. BMC Pulm Med. 2016, 16: 12.
10.	De Vos R, Hicks A, Lomax M, et al. A systematic review of methods of scoring inhaler technique. Respir Med, 2023, 219: 107430.
11.	秦琼, 陈蓉, 雷伟, 等. 哮喘、慢性阻塞性肺疾病患者吸入给药装置依从性评价与分析. 中国药学杂志, 2016, 51(5): 4.
12.	李琴, 刘婷, 张珊, 等. 痛风患者疾病感知评估量表的编制及信效度检验. 中华护理杂志, 2023, 58(7): 836-842.
13.	张凡, 张静萍. 基于Delphi-AHP法多发伤患者ICU护理监测评估量表的构建. 护理学报, 2019, 26(22): 11-15.
14.	史静琤, 莫显昆, 孙振球. 量表编制中内容效度指数的应用. 中南大学学报(医学版), 2012, 37(2): 152-155.
15.	王佳玉, 何竑超, 江哲涵, 等. 基于Delphi-AHP法构建经尿道前列腺切除手术关键技术评价量表. 中国毕业后医学教育, 2023, 7(7): 551-554.
16.	朱若灵, 王胜南, 李利, 等. 基于经典测量理论和层次分析法的老年人综合活力量表的编制. 生理学报, 2023, 75(6): 927-936.
17.	李宁. 基于层次分析法的典型危化品装卸区域风险等级评估研究, 中国石油大学(华东), 2018.
18.	Chabuk A, Al-Ansari N, Hussain HM, et al. Landfill sites selection using MCDM and comparing method of change detection for Babylon Governorate, Iraq. Environ Sci Pollut Res Int, 2019, 26(35): 35325-35339.
19.	Molimard M, Raherison C, Lignot S, et al. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur Respir J, 2017, 49(2): 1601794.
20.	Pascual S, Feimer J, De Soyza A, et al. Preference, satisfaction and critical errors with Genuair and Breezhaler inhalers in patients with COPD: a randomised, cross-over, multicentre study. NPJ Prim Care Respir Med, 2015, 25: 15018.
21.	Mehuys E, Boussery K, Adriaens E, et al. COPD management in primary care: an observational, community pharmacy-based study. Ann Pharmacother, 2010, 44(2): 257-266.
22.	Lenney J, Innes JA, Crompton GK. Inappropriate inhaler use: assessment of use and patient preference of seven inhalation devices. EDICI. Respir Med, 2000, 94(5): 496-500.
23.	Shammber N, Baay A. Assessment of inhalers technique proper use for patients with chronic respiratory diseases in primary and secondary clinics in babylon city. Asian J Pharm Clin Res, 2018, 11(3): 199.

1. 中国医学装备协会呼吸病学专委会吸入治疗与呼吸康复学组. 稳定期慢性气道疾病吸入装置规范应用中国专家共识(2023版). 中华结核和呼吸杂志, 2023, 46(11): 1055-1067.
2. 中国医学装备协会呼吸病学专委会吸入治疗与呼吸康复学组, 中国慢性阻塞性肺疾病联盟. 稳定期慢性气道疾病吸入装置规范应用中国专家共识. 中华结核和呼吸杂志, 2019, 42(4): 241-253.
3. 赵茜, 钮美娥, 吴振云. 呼吸系统疾病患者正确掌握药物吸入技术的研究进展. 中华护理杂志, 2021, 56(9): 1426-1431.
4. Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res, 2018, 19(1): 10.
5. 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.
6. Lewis A, Torvinen S, Dekhuijzen PN, et al. The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries. BMC Health Serv Res, 2016, 16: 251.
7. 黄浠婷, 骆晓琳, 王净, 等. 慢性阻塞性肺疾病患者吸入用药管理的证据总结. 中国护理管理, 2023, 23(11): 1720-1726.
8. Hämmerlein A, Müller U, Schulz M. Pharmacist-led intervention study to improve inhalation technique in asthma and COPD patients. J Eval Clin Pract, 2011, 17(1): 61-70.
9. Chrystyn H, Price DB, Molimard M, et al. Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study. BMC Pulm Med. 2016, 16: 12.
10. De Vos R, Hicks A, Lomax M, et al. A systematic review of methods of scoring inhaler technique. Respir Med, 2023, 219: 107430.
11. 秦琼, 陈蓉, 雷伟, 等. 哮喘、慢性阻塞性肺疾病患者吸入给药装置依从性评价与分析. 中国药学杂志, 2016, 51(5): 4.
12. 李琴, 刘婷, 张珊, 等. 痛风患者疾病感知评估量表的编制及信效度检验. 中华护理杂志, 2023, 58(7): 836-842.
13. 张凡, 张静萍. 基于Delphi-AHP法多发伤患者ICU护理监测评估量表的构建. 护理学报, 2019, 26(22): 11-15.
14. 史静琤, 莫显昆, 孙振球. 量表编制中内容效度指数的应用. 中南大学学报(医学版), 2012, 37(2): 152-155.
15. 王佳玉, 何竑超, 江哲涵, 等. 基于Delphi-AHP法构建经尿道前列腺切除手术关键技术评价量表. 中国毕业后医学教育, 2023, 7(7): 551-554.
16. 朱若灵, 王胜南, 李利, 等. 基于经典测量理论和层次分析法的老年人综合活力量表的编制. 生理学报, 2023, 75(6): 927-936.
17. 李宁. 基于层次分析法的典型危化品装卸区域风险等级评估研究, 中国石油大学(华东), 2018.
18. Chabuk A, Al-Ansari N, Hussain HM, et al. Landfill sites selection using MCDM and comparing method of change detection for Babylon Governorate, Iraq. Environ Sci Pollut Res Int, 2019, 26(35): 35325-35339.
19. Molimard M, Raherison C, Lignot S, et al. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur Respir J, 2017, 49(2): 1601794.
20. Pascual S, Feimer J, De Soyza A, et al. Preference, satisfaction and critical errors with Genuair and Breezhaler inhalers in patients with COPD: a randomised, cross-over, multicentre study. NPJ Prim Care Respir Med, 2015, 25: 15018.
21. Mehuys E, Boussery K, Adriaens E, et al. COPD management in primary care: an observational, community pharmacy-based study. Ann Pharmacother, 2010, 44(2): 257-266.
22. Lenney J, Innes JA, Crompton GK. Inappropriate inhaler use: assessment of use and patient preference of seven inhalation devices. EDICI. Respir Med, 2000, 94(5): 496-500.
23. Shammber N, Baay A. Assessment of inhalers technique proper use for patients with chronic respiratory diseases in primary and secondary clinics in babylon city. Asian J Pharm Clin Res, 2018, 11(3): 199.

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Construction of the rating scale for key techniques using the inhaler device for patients with chronic airway disorder based on the Delphi-AHP method

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