TY - JOUR AU - Rumi, Gabriele AU - Canonica, G Walter AU - Foster, Juliet M AU - Chavannes, Niels H AU - Valenti, Giuseppe AU - continglia, Rosario AU - Rapsomaniki, Eleni AU - Kocks, Janwillem W H AU - De Brasi, Dario AU - Braido, Fulvio PY - 2022 DA - 2022/11/2 TI -意大利使用智能吸入器技术的数字教练改善哮喘患者的哮喘管理:基于社区的研究JO - JMIR Mhealth Uhealth SP - e25879 VL - 10 IS - 11 KW -哮喘控制KW -哮喘管理KW -连接设备KW -数字健康KW - eHealth KW -吸入器KW -维持和缓解治疗KW -移动电话AB -背景:依赖短效β-2激动剂和不坚持维持药物与哮喘临床结果不佳有关。数字健康解决方案可以支持最佳药物使用，从而支持哮喘患者的疾病控制;然而，它们在社区环境中的使用情况尚未确定。目的:本研究的主要目的是调查社区对Turbu+项目的实施情况，该项目旨在支持哮喘自我管理，包括对布地奈德和福莫特罗(Symbicort) turbbuhaler的依从性，这是一种用于维持治疗或维持和缓解治疗的联合吸入器。第二个目标是为医疗保健专业人员提供有关患者在现实生活中如何使用药物的见解。方法:对医生诊断为哮喘的患者开布地奈德和福莫特罗作为维持治疗，剂量为每日2次(1- bid)或每日2次(2- bid)，或作为维持和缓解治疗(1- bid和缓解剂或2- bid和缓解剂在单一吸入器中)，并在意大利各地的二级保健中心接受Turbu+培训。连接患者吸入器≥90天(数据截止)的电子设备安全地将药物使用数据上传到智能手机应用程序，并提供提醒、可视化药物使用和激励提示信息。平均服药依从性定义为监测期间按规定每日维持吸入的比例(每天记录的维持动作次数或每天规定的维持吸入次数)的平均值。坚持天数的比例定义为在给定的一天内采取所有规定的维持吸入的天数的比例。 The Wilcoxon test was used to compare the proportion of adherent days between patients in the maintenance regimen and patients in the maintenance and reliever regimen of a given dose. Results: In 661 patients, the mean (SD) number of days monitored was 217.2 (SD 109.0) days. The average medication adherence (maintenance doses taken/doses prescribed) was 70.2% (108,040/153,820) overall and was similar across the groups (1-BID: 6332/9520, 66.5%; 1‑BID and reliever: 43,578/61,360, 71.0%; 2-BID: 10,088/14,960, 67.4%; 2-BID and reliever: 48,042/67,980, 70.7%). The proportion of adherent days (prescribed maintenance doses/doses taken in a given day) was 56.6% (31,812/56,175) overall and was higher with maintenance and reliever therapy (1-BID and reliever vs 1-BID: 18,413/30,680, 60.0% vs 2510/4760, 52.7%; P<.001; 2-BID and reliever vs 2-BID: 8995/16,995, 52.9% vs 1894/3740, 50.6%; P=.02). Rates of discontinuation from the Turbu+ program were significantly lower with maintenance and reliever therapy compared with maintenance therapy alone (P=.01). Conclusions: Overall, the high medication adherence observed during the study might be attributed to the electronic monitoring and feedback mechanism provided by the Turbu+ program. SN - 2291-5222 UR - https://mhealth.www.mybigtv.com/2022/11/e25879 UR - https://doi.org/10.2196/25879 UR - http://www.ncbi.nlm.nih.gov/pubmed/36322120 DO - 10.2196/25879 ID - info:doi/10.2196/25879 ER -