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台灣病患對於類固醇鼻噴劑之使用感受

The Perception and Use of Corticosteroid Nasal Spray in Taiwan

Abstracts


前言:鼻噴劑是過敏性鼻炎或鼻竇炎的標準治療方式之一。本文以某一廠牌鼻噴劑為例,設法瞭解病患對於類固醇鼻噴劑之使用狀況及主觀感受。 材料及方法:作者自2006年10月1日到2007年3月31日間,在桃園及新竹地區1家區域醫院與2家地區醫院的門診中,針對所有使用過Beclomethasone dipropionate鼻噴劑(Beclomet Nasal Aqua, Orion-konserni,芬蘭)3個月以上的病患,展開問卷調查,共計107名,排除填寫不全者6名後,尚餘101名(男75,女26),年齡48.9±21.3歲。問卷題目包括:藥物成分「類固醇」之認知、使用方式、使用後感受、健保就醫及整體評價等5大項,共計23題。 結果:20名(19.8%)對藥物成分「類固醇」曾感到懼怕,49名(48.5%)之使用頻次及劑量會完全遵照醫矚,但是症狀減輕後,37名(36.6%)會自行停藥。19名(18.8%)未曾閱讀過包裝盒內的使用說明,29名(28.7%)初次拿到藥物時,於隔日才開始使用。17名(16.8%)使用前未搖勻藥劑,19名(18.8%)不曾把鼻孔清乾淨;19名(18.8%)使用時不會配合吸氣動作;52名(51.5%)使用後表示鼻腔會有刺激感,47名(46.5%)表示有怪味道,15名(14.9%)表示會有不舒服的症狀,13名(12.9%)未按理想方式收藏,6名(5.9%)曾把藥劑與他人分享,25名(24.8%)表示每人每月最多領取1瓶並不足夠。就醫拿藥時,59名(58.4%)表示還要需掛號頗麻煩,35名(34.7%)曾等不及想直接把健保卡交給門診護士領取處方箋拿藥,72名(71.3%)認為應該領取慢性連續處方箋。整體而言,36名(35.6%)表示鼻噴劑好用,62名(61.4%)表示還好,3名(3.0%)表示不好用。 結論:醫師應主動向病患說明鼻噴劑理想的使用方法及定期回診的目的,更要設計出更好的就醫流程,並設法減低藥物帶給病患的不適感。

Parallel abstracts


Introduction: Corticosteroid nasal spray is one the standard treatment for allergic rhinitis and rhino-sinusitis. Using one corticosterioid nasal spray, this study investigated patient attitudes toward the medication, adherence to prescribed regimen, and perceived effectiveness. Materials and methods: In this study, we surveyed 101 patients (75 men and 26 women; agerage age 48.9±21.3 years) who had used Beclomethasone dipropionate nasal spray (Beclomet Nasal Aqua, Orion-konserni, Finland) for at least 3 months. The patients were recruited from an otorhinolaryngologist's clinic at one regional hospital and two local hospitals located in Tao-Yuan and Hsin-Chu counties in Taiwan between October 2006 and March 2007. The questionnaire consisted of 5 items and 23 questions, about the patient's pre-conceptions of corticosteroid treatment, the patient's adherence to precribed use and methods of use, satisfaction with its effectiveness, and willingness to return for follow-up. Results: Of the 101 study patients, 20 (19.8%) had a fear of corticosteroid. Forty-nine (48.5%) adhered to prescribed frequency and dosage, though 37 (36.6%) retained the medicine after the problems was resolved. Nineteen (18.8%) did read the introductions included in the packing box. Twenty-nine (28.7%) began using the drug the day after they first got it. Before using the drug, 17 (16.8%) did not shake the bottle and 19 (18.8%) did not clean their nostrils. When using it, 19 (18.8%) did not aspirate at the same time. Fifty-two (51.5%) complained of nasal irritation, 47 (46.5%) reported strange smells, and 15 (14.9%) felt other discomfort besides nasal irritation. Thirteen (12.9%) did not appropriately keep the drug and 6 (5.9%) had shared the drug with others. Twenty-five (24.8%) thought one bottle a month was enough. With regard to follow up, 59 (58.4%) felt it troublesome to register again, 35 (34.7%) had impatiently preferred the order ticket to consultation, and 72 (71.3%) wanted a chronic-disease follow-up order. Over all, 36 (35.6%) thought the drug was effective, and 62 (61.4%) felt it so-so, and three (3.0%) did not find it effective. Conclusion: It is necessary to actively introduce patients to the appropriate usage corticosteroid nasal sprays, inform them of the purpose of follow-up, improve the medical program, and decrease the discomfort caused by the drug.

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