COVID-19 PANDEMİSİ DÖNEMİNDE GÖĞÜS HASTALIKLARI POLİKLİNİĞİ’NE BAŞVURAN HASTALARDA UYGUN İNHALER TEKNİĞİ VE ANKSİYETE İLİŞKİSİNİN DEĞERLENDİRİLMESİ: PROSPEKTİF KESİTSEL BİR ÇALIŞMA

Yıl 2022, Cilt: 46 Sayı: 3, 793 - 804, 30.09.2022

Mefküre Durmuş Selim Gök Ömer Faruk Bahçecioğlu Zeynep Ülkü Gün Süleyman Savaş Hacıevliyagil

https://doi.org/10.33483/jfpau.1111713

Öz

Amaç: Bu çalışmadaki amacımız respiratuvar hastalıkları olan hastaların inhaler kullanma becerileri ile koronovirüs anksiyete skorları ve genel anksiyete skorları arasındaki ilişkiyi belirlemektir.
Gereç ve Yöntem: Yetmiş astım ve kronik obstruktif akciğer hastalığı (KOAH) hastasının inhaler kullanma teknikleri üç klinik eczacı tarafından değerlendirildi. Göğüs Hastalıkları Uzmanı tarafından Hamilton Anksiyete Ölçeği (HAM-A) ve Koronavirüs Anksiyete Ölçeği (CAS) kullanılarak hastaların anksiyete skorları ölçüldü. IBM SPSS 25.0 programı kullanılarak ilgili istatistikler yapıldı.
Sonuç ve Tartışma: Doğru inhaler tekniği ile CAS skoru, yaş, komorbidite, veya inhaler tipi arasında ilişki bulunamamıştır. Doğru inhaler tekniği ile HAM-A seviyesi (p=0,096) ve eğitim durumu (p=0.074) arasında istatistiksel anlamlılık bulunamamıştır. Yaş ile CAS skoru arasında zayıf bir korelasyon bulunmuştur (r=-0.278, p=0.02). Astım hastalarının koronovirüs anksiyete oranı KOAH hastalarına göre anlamlı derecede yüksekti (p=0.036). Kadın hastaların HAM-A (p=0,037) ve CAS skorları (p=0,002) erkek hastalardan anlamlı derecede yüksekti. HAM-A ile CAS skorları arasında orta dereceli bir korelasyon bulunmuştur (r=0.407, p<0.001). HAM-A seviyesi ve inhaler kullanma beceri skorları arasındaki korelasyon anlamlı bulunmamıştır. (r=-0.208, p=0.083)Sonuç olarak, hastaların artmış CAS skorları inhaler kullanma becerilerini etkilememiştir. HAM-A skorları inhaler kullanma becerilerini negatif yönde etkilemiştir fakat sonuç anlamlı değildir.  

Anahtar Kelimeler

Anksiyete, astım, COVID-19, inhaler tekniği, KOAH

EVALUATION OF THE ASSOCIATION BETWEEN PROPER INHALER TECHNIQUE AND ANXIETY IN CHEST DISEASES OUTPATIENT CLINIC PATIENTS DURING COVID-19 PANDEMIC: A PROSPECTIVE CROSS-SECTIONAL STUDY

Öz

Objective: In this study, we aimed to investigate the association between inhaler use skills and general anxiety or coronavirus anxiety scores in patients with respiratory diseases.
Material and Method: Inhaler techniques of 70 asthma and chronic obstructive pulmonary disease (COPD) patients were evaluated by three clinical pharmacists. A pulmonologist assessed the patients' anxiety scores using the Hamilton Anxiety Rating Scale (HAM-A) and Coronavirus Anxiety Scale (CAS). We used IBM SPSS 25.0 as a software program for related statistical analysis
Result and Discussion: Proper inhaler technique wasn’t found to be associated with CAS score, age, comorbidity, inhaler type. HAM-A stage (p=0.096) and educational status (p=0.074) were not found as statistically significant in affecting the proper inhaler technique. A weak correlation was found between age and CAS score (r=-0.278, p=0.02). Asthma patients have a higher rate of coronavirus anxiety than COPD patients (p=0.036). Female patients had higher HAM-A (p=0,037) and CAS scores (p=0,002) than male patients. There was a moderate correlation between HAM-A and CAS scores (r=0.407, p<0.001). The correlation between HAM-A and inhaler use skills scores were not found in statistical significance (r=-0.208, p=0.083). In conclusion, increase of CAS score wasn’t found to be associated with proper inhaler technique. HAM-A score was found to affect proper inhaler technique negatively, but these results are not significant.

Anahtar Kelimeler

Anxiety, asthma, COVID-19, COPD, inhaler technique

Kaynakça

• 1. Jardim, J.R., Nascimento, O.A. (2019). The importance of inhaler adherence to prevent COPD exacerbations. Medical Science (Basel), 7(4), 54-64. [CrossRef]
• 2. George, M., Bender, B. (2019). New insights to improve treatment adherence in asthma and COPD. Patient Preference and Adherence, 13, 1325-1334. [CrossRef]
• 3. Sundbom, L.T., Bingefors K. (2013). The influence of symptoms of anxiety and depression on medication nonadherence and its causes: a population based survey of prescription drug users in Sweden. Patient Preference and Adherence, 7, 805-811. [CrossRef]
• 4. Bauer, L.K., Caro M.A., Beach S.R., Mastromauro, C.A., Lenihan, E., Januzzi, J.L., Huffman, J.C. (2012). Effects of depression and anxiety improvement on adherence to medication and health behaviors in recently hospitalized cardiac patients. The American Journal of Cardiology, 109(9), 1266-1271. [CrossRef]
• 5. Venkata, V.S, Kiernan, G. (2020). Covid-19 and COPD: pooled analysis of observational studies. Chest Annual Meeting, 158(4), A2469. [CrossRef]
• 6. Leung, J.M, Niikura, M., Yang, C.W.T., Sin, D.D. (2020). COVID-19 and COPD. The European Respiratory Journal, 56(2), 2002108. [CrossRef]
• 7. Sancar, M., Sirinoğlu, Y., Okuyan, B., Karagoz, T., Izzettin, F.V. (2015) The effect of pharmacist-led education on inhaler use skills in hospitalised patients with chronic obstructive pulmonary disease. European Journal of Hospital Pharmacy, 22, 366-368. [CrossRef]
• 8. Bryant, L., Bang, C., Chew, C., Baik, S.H., Wiseman, D. (2013) Adequacy of inhaler technique used by people with asthma or chronic obstructive pulmonary disease. Journal of Primary Health Care, 5, 191-198. [CrossRef]
• 9. Batterink, J., Dahri, K., Aulakh, A., Rempel, C. (2012). Evaluation of the use of inhaled medications by hospital inpatients with chronic obstructive pulmonary disease. The Canadian Journal of Hospital Pharmacy, 65, 111-118. [CrossRef]
• 10. Bech, P. (2011). Measuring states of anxiety with clinician-rated and patient-rated scales. In: S. Selek (Ed), Different views of anxiety disorders, (pp.169-84) Crotia: InTech.
• 11. Yazıcı, M., Demir, B., Tanrıverdi, N., Karaaǧaoǧlu, E., Yolaç, P. (1998). Hamilton Anksiyete Değerlendirme Ölçeği, değerlendiriciler arası güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi, 9,114-117.
• 12. GOLD. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. (2020) https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2- Accessed 03.12.2019.
• 13. Yorgancıoğlu, A., Polatlı, M., Aydemir, Ö., Yılmaz Demirci, N., Kırkıl, G., Naycı Atış, S., Köktürk, N., Uysal, A., Akdemir, S.A., Özgür, E.S., Günakan, G. (2012). Reliability and validity of Turkish version of COPD assessment test. Tuberkuloz ve Toraks, 60(4), 314-320. [CrossRef]
• 14. Biçer, İ., Çakmak, C., Demir, H., Kurt, M.E. (2020). Koronavirüs Anksiyete Ölçeği Kısa Formu: Türkçe Geçerlik ve Güvenirlik Çalışması. Anadolu Kliniği Tıp Bilimleri Dergisi, 25, 216-225. [CrossRef]
• 15. Kühl, K., Schürmann, W., Rief, W. (2008). Mental disorders and quality of life in COPD patients and their spouses. International Journal of Chronic Obstructive Pulmonary Disease, 3, 727-736. [CrossRef]
• 16. Carvalho, N.S., Ribeiro, P.R., Ribeiro, M., Nunes, P.T., Cukier A., Stelmach R. (2007). Comparing asthma and chronic obstructive pulmonary disease in terms of symptoms of anxiety and depression. Jornal Brasileiro de Pneumologia, 33, 1-6. [CrossRef]
• 17. Yohannes A.M. (2021). COPD patients in a COVID-19 society: depression and anxiety. Expert Rewiev of Respiratory Medicine, 15(1), 5-7. [CrossRef]
• 18. Oraka, E., King, M.E., Callahan, D.B. (2010). Asthma and serious psychological distress: prevalence and risk factors among US adults, 2001-2007. Chest Journal, 137, 609-616. [CrossRef]
• 19. Kunik, M.E., Roundy, K., Veazey, C., Souchek J., Richardson, P., Wray, N.P., Stanley, M.A. (2005). Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest Journal, 127, 1205-1211. [CrossRef]
• 20. Philip, K.E.J., Lonergan, B., Cumella, A., Farrington-Douglas, J., Laffan, M., Hopkinson, N.S. (2020). COVID-19 related concerns of people with long-term respiratory conditions: a qualitative study. BioMedCentral Pulmonary Medicine, 20, 1-10. [CrossRef]
• 21. Júnior, J.L.R.S., Conde, M.B., de Sousa Corrêa, K., da Silva, C., da Silva Prestes, L., Rabahi, M.F. (2014). COPD Assessment Test (CAT) score as a predictor of major depression among subjects with chronic obstructive pulmonary disease and mild hypoxemia: a case–control study. BioMedCentral Pulmonary Medicine, 14, 186-192. [CrossRef]
• 22. Hilmarsen, C.W., Wilke, S., Engan, H., Spruit, M.A., Rodenburg J., Janssen, D.J.A., Steinshamn, S., Jones, P.W., Wouters, E.F.M., Oldervoll L., Franssen, F.M.E. (2014). Impact of symptoms of anxiety and depression on COPD Assessment Test scores. European Respiratory Journal, 43, 898-900. [CrossRef]
• 23. Long J, Ouyang Y, Duan H, Xiang Z., Ma, H., Ju, M., Sun, D. (2020). Multiple factor analysis of depression and/or anxiety in patients with acute exacerbation chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 15, 1449-1464. [CrossRef]
• 24. Lee Y.S., Park S., Oh Y-M., Lee S-D., Park S-W., Kim, Y.S., In, K.H., Jung, B.H., Lee, K.H., Ra, S.W., Hwang, Y.I., Park, Y-B., Jung, K-S. (2013). Chronic obstructive pulmonary disease assessment test can predict depression: a prospective multi-center study. Journal of Korean Medical Science, 28, 1048-1054. [CrossRef]
• 25. Jones, P., Harding, G., Berry, P., Jones, P.W., Harding, G., Berry, P., Wiklund, I., Chen, W-H., Leidy, N.K. (2009) Development and first validation of the COPD Assessment Test. The European Respiratory Journal, 34, 648-654. [CrossRef]
• 26. E. Hesselink BWP, Hanneke AH Wijnhoven, Didi MW Kriegsman, Jacques TM van Eijk, Arlette. (2001). Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scandinavian Journal of Primary Health Care, 19, 255-260. [CrossRef]
• 27. Amini, S., Ghasemi, A., Solduzian, M., Rahimi, B., Heidari, M.K., Hadjibabaie, M., Kargar, M. (2020). Is Inhaler Technique Associated with Quality of Life in Patients with Chronic Obstructive Pulmonary Disease? Current Therapeutic Research, 93, 608-614. [CrossRef]
• 28. Gregoriano, C., Dieterle, T., Breitenstein, A-L., Dürr, S., Baum, A., Maier, S., Arnet, I., Hersberger, K.E., Leuppi, J.D. (2018). Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respiratory Research, 19, 1-15. [CrossRef]
• 29. van Beerendonk, I., Mesters, I., Mudde, A.N., Tan, T. (1998). Assessment of the inhalation technique in outpatients with asthma or chronic obstructive pulmonary disease using a metered-dose inhaler or dry powder device. The Journal of Asthma, 35, 273-279. [CrossRef]
• 30. Bosley, C., Fosbury, J., Cochrane, G. (1995). The psychological factors associated with poor compliance with treatment in asthma. The European Respiratory Journal, 8, 899-904.
• 31. Sulaiman, I., Cushen, B., Greene, G., Seheult, J., Seow, D., Rawat, F., MacHale, E., Mokoka, M., Moran, C.N., Sartini Bhreathnach, A., MacHale, P., Tappuni, S., Deering, B., Jackson, M., McCarthy, H., Mellon, L., Doyle, F., Boland, F., Reilly, R.B., Costello, R.W. (2017). Objective assessment of adherence to inhalers by patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 195, 1333-1343. [CrossRef]
• 32. Zhang, H-Q., Lin, J-Y., Guo, Y., Pang, S., Jiang, R., Cheng, Q-J. (2020). Medication adherence among patients with chronic obstructive pulmonary disease treated in a primary general hospital during the COVID-19 pandemic. Annals of Translational Medicine, 8, 1179-1188. [CrossRef]