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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The study of the association between geriatric profile and the use of inhaled respiratory drugs would help to identify age-related factors that might indicate poor inhaler use and technique&#46;</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We selected 117 patients older than 74 years receiving chronic treatment with inhaled respiratory drugs to participate in this descriptive&#44; cross-sectional&#44; multicenter study&#46; The following variables were analyzed&#58; age&#44; sex&#44; institutionalization&#44; carer assistance&#44; inhaled drugs&#44; prescribed regimen&#44; actual regimen followed by the patient&#44; initial indication&#44; concomitant use of drugs that could exacerbate the underlying disease&#44; adverse effects&#44; basic geriatric assessment scores&#44; treatment adherence&#44; inhalation technique&#44; and spirometric variables&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">In all&#44; 5&#46;4&#37; of the patients had moderate to severe cognitive impairment&#59; 2&#46;2&#37;&#44; considerable or total dependency in terms of activities of daily living&#59; and&#44; 14&#37;&#44; considerable or total dependency in terms of instrumental activities of daily living&#46; Twenty-three percent had symptoms of depression and 5&#46;4&#37; &#40;all men&#41; were depressed&#46; Forty percent of the patients analyzed were considered to be at psychosocial risk&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Inhalation technique scores were not correlated with any of the other variables analyzed&#46; Higher scores were obtained when dry powder inhalers were used to administer anticholinergic agents and when capsule-based inhalers were used to administer corticosteroids concomitantly with long-acting &#946;<span class="elsevierStyleInf">2</span>-agonists&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Tests readily administered in daily practice to detect age-related deterioration may not accurately predict optimal use of inhaler devices&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El estudio de la asociaci&#243;n entre perfil geri&#225;trico y uso de medicaci&#243;n respiratoria inhalada permitir&#237;a conocer qu&#233; factores relacionados con el envejecimiento pueden condicionar la utilizaci&#243;n y la t&#233;cnica de administraci&#243;n de estos f&#225;rmacos&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes Y M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio multic&#233;ntrico&#44; descriptivo y transversal en que se incluy&#243; a 117 pacientes mayores de 74 a&#241;os&#44; en tratamiento cr&#243;nico con f&#225;rmacos respiratorios por v&#237;a inhalada&#46; Se analizaron las siguientes variables&#58; edad&#44; sexo&#44; institucionalizaci&#243;n&#44; cuidador&#44; f&#225;rmacos inhalados de acci&#243;n respiratoria&#44; pauta prescrita y realizada por el paciente&#44; diagn&#243;stico que origin&#243; la prescripci&#243;n&#44; f&#225;rmacos concomitantes que pudieran agravar la enfermedad de base&#44; efectos adversos&#44; valoraci&#243;n geri&#225;trica b&#225;sica&#44; cumplimiento terap&#233;utico&#44; valoraci&#243;n de la t&#233;cnica de inhalaci&#243;n y variables espirom&#233;tricas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El 5&#44;4&#37; de los pacientes presentaba un deterioro cognitivo moderado-grave&#44; el 2&#44;2&#37; una dependencia funcional importante-total y el 14&#37; una dependencia instrumental importante-total&#46; El 23&#37; ten&#237;a depresi&#243;n leve y el 5&#44;4&#37; depresi&#243;n establecida&#44; siendo todos los pacientes varones&#46; El 40&#37; presentaba riesgo social&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">La valoraci&#243;n de la t&#233;cnica no se correlacion&#243; con ninguna de las variables analizadas&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Los dispositivos Aerolizer-Handihaler mejoraban la valoraci&#243;n de la t&#233;cnica en la aplicaci&#243;n de los anticolin&#233;rgicos y los dispositivos Accuhaler-Turbuhaler&#44; la aplicaci&#243;n de la asociaci&#243;n de corticoides con agonistas adren&#233;rgicos &#946;<span class="elsevierStyleInf">2</span> de acci&#243;n larga&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los tests de f&#225;cil aplicaci&#243;n en consulta para detectar el deterioro asociado al envejecimiento no parecen ser un buen elemento predictivo para determinar un mejor uso de los dispositivos de inhalaci&#243;n&#46;</p>"
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Vol. 44. Issue 10.
Pages 519-524 (January 2008)
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Vol. 44. Issue 10.
Pages 519-524 (January 2008)
Original Articles
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Inhaled Drug Use in Elderly Patients and Limitations in Association With Geriatric Assessment Scores
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Ventura Rabell-Santacanaa,
Corresponding author
verabell.ics@gencat.net

Correspondence: Dr V. Rabell-Santacana Unidad de Neumología, Nivel hospitalario, CAP II, Institut Català de la Salut Museu, 19, 1.º 08400 Granollers, Barcelona, Spain
, Esther Pastor-Ramonb, Juan Pujol-Ribóc, Juan Solà-Genovésd, Montserrat Díaz-Egeac, Miquel Layola-Briasb, María Dolores Fernández-Campie
a Unidad de Neumología, Nivel hospitalario, CAP II Granollers, Granollers, Barcelona, Spain
b Unidad de Farmacia, Servicio de Atención Primaria Granollers-Mollet del Vallès, Granollers, Barcelona, Spain
c Unidad de Neumología, Nivel hospitalario, CAP II Mollet, Mollet del Vallès, Barcelona, Spain
d Programa de Atención Domiciliaria Estructura Soporte Mollet, Mollet del Vallès, Barcelona, Spain
e Centro de Salud Montornès, Equipo de Atención Primaria, Área Básica de Salud Montornés-Montmeló, Barcelona, Spain
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Objective

The study of the association between geriatric profile and the use of inhaled respiratory drugs would help to identify age-related factors that might indicate poor inhaler use and technique.

Patients and Methods

We selected 117 patients older than 74 years receiving chronic treatment with inhaled respiratory drugs to participate in this descriptive, cross-sectional, multicenter study. The following variables were analyzed: age, sex, institutionalization, carer assistance, inhaled drugs, prescribed regimen, actual regimen followed by the patient, initial indication, concomitant use of drugs that could exacerbate the underlying disease, adverse effects, basic geriatric assessment scores, treatment adherence, inhalation technique, and spirometric variables.

Results

In all, 5.4% of the patients had moderate to severe cognitive impairment; 2.2%, considerable or total dependency in terms of activities of daily living; and, 14%, considerable or total dependency in terms of instrumental activities of daily living. Twenty-three percent had symptoms of depression and 5.4% (all men) were depressed. Forty percent of the patients analyzed were considered to be at psychosocial risk.

Inhalation technique scores were not correlated with any of the other variables analyzed. Higher scores were obtained when dry powder inhalers were used to administer anticholinergic agents and when capsule-based inhalers were used to administer corticosteroids concomitantly with long-acting β2-agonists.

Conclusions

Tests readily administered in daily practice to detect age-related deterioration may not accurately predict optimal use of inhaler devices.

Key words:
Inhaler use
Geriatric assessment
Inhaler technique
Objetivo

El estudio de la asociación entre perfil geriátrico y uso de medicación respiratoria inhalada permitiría conocer qué factores relacionados con el envejecimiento pueden condicionar la utilización y la técnica de administración de estos fármacos.

Pacientes Y Métodos

Se ha realizado un estudio multicéntrico, descriptivo y transversal en que se incluyó a 117 pacientes mayores de 74 años, en tratamiento crónico con fármacos respiratorios por vía inhalada. Se analizaron las siguientes variables: edad, sexo, institucionalización, cuidador, fármacos inhalados de acción respiratoria, pauta prescrita y realizada por el paciente, diagnóstico que originó la prescripción, fármacos concomitantes que pudieran agravar la enfermedad de base, efectos adversos, valoración geriátrica básica, cumplimiento terapéutico, valoración de la técnica de inhalación y variables espirométricas.

Resultados

El 5,4% de los pacientes presentaba un deterioro cognitivo moderado-grave, el 2,2% una dependencia funcional importante-total y el 14% una dependencia instrumental importante-total. El 23% tenía depresión leve y el 5,4% depresión establecida, siendo todos los pacientes varones. El 40% presentaba riesgo social.

La valoración de la técnica no se correlacionó con ninguna de las variables analizadas.

Los dispositivos Aerolizer-Handihaler mejoraban la valoración de la técnica en la aplicación de los anticolinérgicos y los dispositivos Accuhaler-Turbuhaler, la aplicación de la asociación de corticoides con agonistas adrenérgicos β2 de acción larga.

Conclusiones

Los tests de fácil aplicación en consulta para detectar el deterioro asociado al envejecimiento no parecen ser un buen elemento predictivo para determinar un mejor uso de los dispositivos de inhalación.

Palabras clave:
Uso de inhaladores
Evaluación geriátrica
Técnica de administración
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