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.	中國醫學裝備協會呼吸病學專委會吸入治療與呼吸康復學組. 穩定期慢性氣道疾病吸入裝置規范應用中國專家共識(2023版). 中華結核和呼吸雜志, 2023, 46(11): 1055-1067.
2.	中國醫學裝備協會呼吸病學專委會吸入治療與呼吸康復學組, 中國慢性阻塞性肺疾病聯盟. 穩定期慢性氣道疾病吸入裝置規范應用中國專家共識. 中華結核和呼吸雜志, 2019, 42(4): 241-253.
3.	趙茜, 鈕美娥, 吳振云. 呼吸系統疾病患者正確掌握藥物吸入技術的研究進展. 中華護理雜志, 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.	黃浠婷, 駱曉琳, 王凈, 等. 慢性阻塞性肺疾病患者吸入用藥管理的證據總結. 中國護理管理, 2023, 23(11): 1720-1726.
8.	H?mmerlein 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-na?ve 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.	秦瓊, 陳蓉, 雷偉, 等. 哮喘、慢性阻塞性肺疾病患者吸入給藥裝置依從性評價與分析. 中國藥學雜志, 2016, 51(5): 4.
12.	李琴, 劉婷, 張珊, 等. 痛風患者疾病感知評估量表的編制及信效度檢驗. 中華護理雜志, 2023, 58(7): 836-842.
13.	張凡, 張靜萍. 基于Delphi-AHP法多發傷患者ICU護理監測評估量表的構建. 護理學報, 2019, 26(22): 11-15.
14.	史靜琤, 莫顯昆, 孫振球. 量表編制中內容效度指數的應用. 中南大學學報(醫學版), 2012, 37(2): 152-155.
15.	王佳玉, 何竑超, 江哲涵, 等. 基于Delphi-AHP法構建經尿道前列腺切除手術關鍵技術評價量表. 中國畢業后醫學教育, 2023, 7(7): 551-554.
16.	朱若靈, 王勝南, 李利, 等. 基于經典測量理論和層次分析法的老年人綜合活力量表的編制. 生理學報, 2023, 75(6): 927-936.
17.	李寧. 基于層次分析法的典型危化品裝卸區域風險等級評估研究, 中國石油大學(華東), 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. 中國醫學裝備協會呼吸病學專委會吸入治療與呼吸康復學組. 穩定期慢性氣道疾病吸入裝置規范應用中國專家共識(2023版). 中華結核和呼吸雜志, 2023, 46(11): 1055-1067.
2. 中國醫學裝備協會呼吸病學專委會吸入治療與呼吸康復學組, 中國慢性阻塞性肺疾病聯盟. 穩定期慢性氣道疾病吸入裝置規范應用中國專家共識. 中華結核和呼吸雜志, 2019, 42(4): 241-253.
3. 趙茜, 鈕美娥, 吳振云. 呼吸系統疾病患者正確掌握藥物吸入技術的研究進展. 中華護理雜志, 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. 黃浠婷, 駱曉琳, 王凈, 等. 慢性阻塞性肺疾病患者吸入用藥管理的證據總結. 中國護理管理, 2023, 23(11): 1720-1726.
8. H?mmerlein 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-na?ve 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. 秦瓊, 陳蓉, 雷偉, 等. 哮喘、慢性阻塞性肺疾病患者吸入給藥裝置依從性評價與分析. 中國藥學雜志, 2016, 51(5): 4.
12. 李琴, 劉婷, 張珊, 等. 痛風患者疾病感知評估量表的編制及信效度檢驗. 中華護理雜志, 2023, 58(7): 836-842.
13. 張凡, 張靜萍. 基于Delphi-AHP法多發傷患者ICU護理監測評估量表的構建. 護理學報, 2019, 26(22): 11-15.
14. 史靜琤, 莫顯昆, 孫振球. 量表編制中內容效度指數的應用. 中南大學學報(醫學版), 2012, 37(2): 152-155.
15. 王佳玉, 何竑超, 江哲涵, 等. 基于Delphi-AHP法構建經尿道前列腺切除手術關鍵技術評價量表. 中國畢業后醫學教育, 2023, 7(7): 551-554.
16. 朱若靈, 王勝南, 李利, 等. 基于經典測量理論和層次分析法的老年人綜合活力量表的編制. 生理學報, 2023, 75(6): 927-936.
17. 李寧. 基于層次分析法的典型危化品裝卸區域風險等級評估研究, 中國石油大學(華東), 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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