RESUMEN
Fundamento y objetivo: Valorar si una intervención educativa sobre la utilización de dispositivos de inhalación mejora el estado funcional de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC).Pacientes y método: Ensayo clínico aleatorizado controlado, con diseo en paralelo y simple ciego, realizado en un centro de salud con 94 pacientes diagnosticados de EPOC y que usaban dispositivos de inhalación. Se asignó a los participantes aleatorizadamente en 2 grupos: el grupo de intervención, al que se le realizó una sesión de adiestramiento sobre el uso de inhaladores al inicio del estudio y otra de refuerzo al mes, y el grupo control, con seguimiento habitual. El principal resultado a medir fue la variación en el índice sintético de BODE (Body-Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity).Resultados: Los pacientes del grupo de intervención (n=48) experimentaron una mejoría en la sensación de disnea, que disminuyó 0,85 puntos (intervalo de confianza [IC] del 95%: −1,14 a −0,56) en la escala de disnea Modified Medical Research Council, mientras que el grupo control (n=46) no experimentó ningún cambio (p<0,0001). En cuanto a la prueba de la marcha, los del grupo de intervención caminaron 6,19 metros más (IC del 95%: −4,02 a 16,40), mientras que el grupo control caminó 20,55 metros menos (IC del 95%: −37,80 a −3,28), con diferencias significativas (p=0,009).Resultados: El índice de BODE disminuyó (mejoró) - 0,82 puntos en el grupo de intervención (IC del 95%: −1,16 a −0,46) y aumentó (empeoró) 0,20 puntos en el grupo control (IC del 95%:−0,16 a 0,56) (p<0,0001).Conclusiones: Los pacientes con EPOC que reciben un adiestramiento específico sobre el uso de inhaladores experimentan una mejoría de su estado funcional comparados con aquellos con seguimiento habitual (AU)
Background and objective: We aimed yo assess whether an educational intervention on the use of inhalational devices improve the functional status of patients with COPD. Patients and method: Randomized controlled trial with parallel design and simple blind trial performed in a clinic with 94 patients diagnosed with COPD and who used inhaled devices. Participants were randomized into 2 groups: the intervention group held a training session on the use of inhalers at baseline and one month and strengthening the control group with routine monitoring. The main outcome measure was the change in the synthetic index BODE (Body-Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity). Results: Patients in the intervention group (n=48) experienced an improvement in the sensation of breathlessness decreasing by 0.85 points (95% CI −1.14 to −0.56) on the MMRC dyspnea scale, while the control group (n=46) did not show any significant change p<0.0001. On the walking test the intervention group walked 6.19 meters (95% CI −4.02 to 16.40) while the control group walked 20.55 meters lower (95% CI −37.80 to −3.28), significant differences with p=0.009. Results: The BODE index decreased (improved) −0.82 points in the intervention group (95% CI −1.16 to −0.46) and increased (worsened) 0.20 in control group (95% CI −0.16 to 0.56) p<0.0001. Conclusions: Patients with COPD who receive specific training on inhaler use as compared with those with regular monitoring experience improvement in their functional state (AU)
Asunto(s)
Humanos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Nebulizadores y Vaporizadores , Administración por Inhalación , Educación del Paciente como Asunto/métodos , Evaluación de Eficacia-Efectividad de Intervenciones , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND AND OBJECTIVE: We aimed yo assess whether an educational intervention on the use of inhalational devices improve the functional status of patients with COPD. PATIENTS AND METHOD: Randomized controlled trial with parallel design and simple blind trial performed in a clinic with 94 patients diagnosed with COPD and who used inhaled devices. Participants were randomized into 2 groups: the intervention group held a training session on the use of inhalers at baseline and one month and strengthening the control group with routine monitoring. The main outcome measure was the change in the synthetic index BODE (Body-Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity). RESULTS: Patients in the intervention group (n=48) experienced an improvement in the sensation of breathlessness decreasing by 0.85 points (95% CI -1.14 to -0.56) on the MMRC dyspnea scale, while the control group (n=46) did not show any significant change p<0.0001. On the walking test the intervention group walked 6.19 meters (95% CI -4.02 to 16.40) while the control group walked 20.55 meters lower (95% CI -37.80 to -3.28), significant differences with p=0.009. The BODE index decreased (improved) -0.82 points in the intervention group (95% CI -1.16 to -0.46) and increased (worsened) 0.20 in control group (95% CI -0.16 to 0.56) p<0.0001. CONCLUSIONS: Patients with COPD who receive specific training on inhaler use as compared with those with regular monitoring experience improvement in their functional state.