ASSESSMENT OF INHALERS TECHNIQUE PROPER USE FOR PATIENTS WITH CHRONIC RESPIRATORY DISEASES IN PRIMARY AND SECONDARY CLINICS IN BABYLON CITY
DOI:
https://doi.org/10.22159/ajpcr.2018.v11i3.23481Keywords:
Inhaler, Proper technique, Chronic respiratory diseases, Babylon cityAbstract
 Objective: Although the inhalers are the preferred method of medications delivery, evidences suggest that many patients are unable to use their inhalers effectively due to improper technique so patients must know the right way of their inhaler use. The aim of the study is to assess the patient's ability to use their inhalers properly, identify the most common error made, assess the benefit of single education session, compare the property of the use between the primary and secondary clinics patients, determine which type of the inhaler devices is associated with more errors, and to identify the association between the inhaler technique and the disease control.
Methods: Non-randomized interventional study was done on 100 inhaler users of three inhaler types (metered-dose inhaler [p MDI], Turbuhaler, or Handihaler) for chronic respiratory diseases. Inhaler technique was evaluated by a scoring system before and after single session of training.
Results: It had been shown that the current education about inhalers techniques was not sufficient. The response to single session of education was higher with high level of education, urban area, and specialized respiratory center. Better disease control with the better score. After training, the younger patients have higher score.
Conclusion: We conclude that we need to stress on the most reported defect, metered-dose inhaler had the lowest mean score; therefore, it needs more training. Furthermore, single class of training can be beneficial but need follow-up to see if this effect can be maintained.
Downloads
References
Al-Jahdali H, Ahmed A, Al-Harbi A, Khan M, Baharoon S, Bin Salih S, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol 2013;9:8.
Hardwell A, Barber V, Hargadon T, McKnight E, Holmes J, Levy ML, et al. Technique training does not improve the ability of most patients to use pressurised metered-dose inhalers (pMDIs). Prim Care Respir J 2011;20:92-6.
Hasanain G, Abood HA, Al-Mousaw AM, Al-Hatab SJ, Al-Obaidi IA, Abutiheen AA, et al. Technical errors in using inhalers among patients with asthma or COPD in Iraq. Iraqi J Med Sci 2017;15:4-12.
Ahmad S, Ismail NE. Stigma in the lives of asthma patients: A review from the literature. Int J Pharm Pharm Sci 2015;7:40-6.
Plaza V, Sanchis J. Medical personnel and patient skill in the use of metered dose inhalers: A multicentric study. CESEA group. Respiration 1998;65:195-8.
Smyth HD. The influence of formulation variables on the performance of alternative propellant-driven metered dose inhalers. Adv Drug Deliv Rev 2003;55:807-28.
Zhou QT, Tang P, Leung SS, Chan JG, Chan HK. Emerging inhalation aerosol devices and strategies: Where are we headed? Adv Drug Deliv Rev 2014;75:3-17.
Giner J, Roura P, Torres B, Burgos F, Castillo D, Tarragona E, Plaza V. Knowledge, attitudes and preferences among spanish community pharmacists regarding inhaled therapy (the optim pharmacy study). Int J Pharm Pharm Sci 2016;8:53-60.
Murphy A. How to help patients to optimize their inhaler technique. Pharm J 2016;297:7891.
Ashurst II, Malton A, Prime D, Sumby B. Latest advances in the development of dry powder inhalers. Pharm Sci Technolo Today 2000;3:246-56.
Atkins PJ. Dry powder inhalers: An overview. Respir Care 2005;50:1304-12.
Bains BK, Birchall JC, Toon R, Taylor G. In vitro reporter gene transfection via plasmid DNA delivered by metered dose inhaler. J Pharm Sci 2010;99:3089-99.
Basheti IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique. Patient Educ Couns 2011; ???:???.
Basheti IA, Reddel HK, Armour CL, Bosnic-Anticevich SZ. Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists. J Allergy Clin Immunol 2007;119:1537-8.
Bjermer L. The importance of continuity in inhaler device choice for asthma and chronic obstructive pulmonary disease. Respiration 2014;88:346-52.
Bosnic-Anticevich SZ, Sinha H, So S, Reddel HK. Metered-dose inhaler technique: The effect of two educational interventions delivered in community pharmacy over time. J Asthma 2010;47:251-6.
British Thoracic Society/Scottish Intercollegiate Guidelines Network. British Guideline on the Management of Asthma. Clinical Guideline No. 141; 2014. Available from: https://www.brit-thoracic.org.uk/document-library/clinical.
Center of Disease Control and Prevention; 2017. Available from: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm.
Crompton GK, Barnes PJ, Broeders M, Corrigan C, Corbetta L, Dekhuijzen R, et al. The need to improve inhalation technique in europe: A report from the aerosol drug management improvement team. Respir Med 2006;100:1479-94.
van der Palen J, Thomas M, Chrystyn H, Sharma RK, van der Valk PD, Goosens M, et al. A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: Comparison of ELLIPTA with other inhaler devices. NPJ Prim Care Respir Med 2016;26:16079.
Al-Showair RA, Tarsin WY, Assi KH, Pearson SB, Chrystyn H. Can all patients with COPD use the correct inhalation flow with all inhalers and does training help? Respir Med 2007;101:2395-401.
Souza ML, Meneghini AC, Ferraz E, Vianna EO, Borges MC. Knowledge of and technique for using inhalation devices among asthma patients and COPD patients. J Bras Pneumol 2009;35:824 31.
Rahmati H, Ansarfard F, Ghodsbin F, Ghayumi MA, Sayadi M. The effect of training inhalation technique with or without spacer on maximum expiratory flow rate and inhaler usage skills in asthmatic patients: A Randomized controlled trial. Int J Community Based Nurs Midwifery 2014;2:211-9.
Madkour A, Galal I. Do egyptian patients use their inhalers correctly? A checklist auditing for inhalation devices usage techniques. Egypt J Chest Dis Tuberc 2015;64:497-504.
Dalcin Pde T, Grutcki DM, Laporte PP, Lima PB, Menegotto SM, Pereira RP, et al. Factors related to the incorrect use of inhalers by asthma patients. J Bras Pneumol 2014;40:13-20.
Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med J 2011;105:930-8
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
