A Tablet-Based Multimedia Education Tool Improves Provider and Subject Knowledge of Inhaler Use Techniques

Mulhall, Aaron M.; Zafar, Muhammad Ahsan; Record, Samantha; Channell, Herman; Panos, Ralph J.

doi:10.4187/respcare.05008

Cited by 17 publications

(29 citation statements)

References 28 publications

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“…A although the results were highly discrepant because half of the studies found improvement in these outcomes, whereas the other half did not. Meta‐analysis including only RCTs did not find significant improvement in quality of life, although a sensitivity analysis including only the two studies that used the St. George's Respiratory Questionnaire showed an improvement of 3.57 points in mean score (95% CI=0.36–6.78). No relevant characteristics seemed to differentiate the studies with regard to these findings, but detailed analysis of the RCTs showed that longer follow‐up was associated with a more significant positive effect on quality of life .…”

Section: Resultsmentioning

confidence: 89%

“…Meta‐analysis including only RCTs did not find significant improvement in quality of life, although a sensitivity analysis including only the two studies that used the St. George's Respiratory Questionnaire showed an improvement of 3.57 points in mean score (95% CI=0.36–6.78). No relevant characteristics seemed to differentiate the studies with regard to these findings, but detailed analysis of the RCTs showed that longer follow‐up was associated with a more significant positive effect on quality of life . Nevertheless, the magnitude of these effects was small, and with wide CIs, and was associated with overall moderate strength of evidence.…”

Section: Resultsmentioning

confidence: 98%

“…No relevant characteristics seemed to differentiate the studies with regard to these findings, but detailed analysis of the RCTs showed that longer follow-up was associated with a more significant positive effect on quality of life. 36,38 Nevertheless, the magnitude of these effects was small, and with wide CIs, and was associated with overall moderate strength of evidence.…”

Section: Disease Controlmentioning

confidence: 91%

“…All studies evaluated the effect of intervention on several aspects of disease control, mainly on quality of life and symptoms. A although the results were highly discrepant because half of the studies found improvement in these outcomes 36,37,39,40 , whereas the other half did not 16,17,35,38 . Meta-analysis including only RCTs did not find significant improvement in quality of life, although a sensitivity analysis including only the two studies that used the St. George's Respiratory Questionnaire 36,38 showed an improvement of 3.57 points in mean score (95% CI=0.…”

Section: Disease Controlmentioning

confidence: 98%

“…Of the eight studies included, four had a randomized design, 16,[35][36][37] and the remaining four had a quasi-randomized pre-and post-intervention design 17,[38][39][40] (details in Supplementary Appendix S3).…”

Section: Description Of Studiesmentioning

confidence: 99%

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Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta‐Analysis

Maricoto

Monteiro

Gama

et al. 2018

J American Geriatrics Society

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Objectives To evaluate the effect of inhaler education programs on clinical outcomes and exacerbation rates in older adults with asthma or chronic obstructive pulmonary disease (COPD). Design Systematic review and meta‐analysis. Setting and Participants Older adults with asthma or COPD, either in primary or secondary health care and pharmacy setting. Measurements We searched the Medline, Embase, and Central databases according to the main eligibility criteria for inclusion: systematic reviews, meta‐analysis, clinical trials and quasi‐experimental studies; participants aged 65 and older; education on inhaler technique and reporting of disease control and exacerbation rates. We used the Grading of Recommendations, Assessment, Development and Evaluations scale for quality assessment and used a random‐effect model with Mantel–Haenszel adjustment to perform a meta‐analysis. Results We included 8 studies (4 randomized, 4 quasi‐experimental) with a total of 1,812 participants. The most frequent type of intervention was physical demonstration of inhaler technique, training with placebo devices. Five studies showed significant reduction in exacerbation rates (pooled risk ratio=0.71, 95% confidence interval=0.59–0.86; p < .001), although effect on disease control and quality of life showed high discrepancy in the reported results, and all randomized studies revealed uncertainty in their risk of bias assessment. Conclusion All interventions seemed to improve inhaler performance and clinically relevant outcomes, but a placebo device could be the most effective. There is evidence that interventions reduce exacerbation risk in older adults, although to an overall moderate degree. J Am Geriatr Soc 67:57–66, 2019.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 98%

Section: Disease Controlmentioning

confidence: 91%

Section: Disease Controlmentioning

confidence: 98%

Section: Description Of Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta‐Analysis

Maricoto

Monteiro

Gama

et al. 2018

J American Geriatrics Society

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Pharmacist‐led inhaler training for nurses on an acute care pulmonary unit

Johnson

Franks

Bullock

et al. 2022

J Am Coll Clin Pharm

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Introduction: Appropriate inhaler technique is important for optimizing treatment of pulmonary conditions, including asthma and chronic obstructive pulmonary disease.Nurses often administer inhaled medications in the acute care setting, providing an opportunity to educate patients on appropriate inhaler technique. To date, no published study has evaluated the impact of pharmacist-led training on skill improvement and retention among acute care pulmonary nursing staff regarding their ability to instruct a patient on inhaler technique.Objective: The primary objective of this study was to evaluate both the immediate and sustained impact of pharmacist-led inhaler technique for acute care pulmonary nurses using hands-on training for instructing on appropriate inhaler use. Methods: This prospective study used a one group pre-test, posttest design for an educational intervention. Pharmacists conducted a brief in-service followed by an individualized simulation where the nurse participant instructed a standardized patient on how to use a placebo metered dose inhaler (MDI) and dry powder inhaler (DPI) before and after receiving individual technique training by a pharmacist. Participant inhaler counseling technique was assessed via standardized checklist. Nurses then received individual coaching from a pharmacist regarding proper inhaler technique. After the pharmacist intervention, the nurse again counseled the standardized patient on how to use the devices. Measures included investigator rating on inhaler technique at baseline, after training, and 2 months later. Results: After the interventions, participant performance significantly improved for MDI and DPI technique. At the 2-month follow-up, there was a statistically significant increase for MDI and DPI technique from baseline. Conclusion: Brief, pharmacist-led inhaler technique education results in sustained improvements in inhaler administration skills among pulmonary nursing staff.

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Errors in inhaler use related to devices and to inhalation technique among patients with chronic obstructive pulmonary disease in primary health care

et al. 2019

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AimThe aim of this study was to describe inhaler use in primary health care patients with chronic obstructive pulmonary disease (COPD) and to categorize these patients into those making errors related to devices, those making errors related to inhalation technique and those making errors related to both.DesignObservational study.MethodsCOPD nurses used a checklist to assess the use of inhalers by patients with spirometry‐verified COPD (N = 183) from primary healthcare centres. The STROBE checklist has been used.ResultsThe mean age of the patients was 71 (SD 9) years. Almost half of them (45%) made at least one error; of these, 50% made errors related to devices, 31% made errors related to inhalation technique and 19% made errors related both to devices and to inhalation technique.

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A Tablet-Based Multimedia Education Tool Improves Provider and Subject Knowledge of Inhaler Use Techniques

Abstract: A tablet-based inhaler education tool improved inhaler technique for both providers and subjects. Although this intervention did show durable efficacy for improving inhaler use by patients, it did not reduce their respiratory symptoms.

Cited by 17 publications

References 28 publications

Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta‐Analysis

Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta‐Analysis

Pharmacist‐led inhaler training for nurses on an acute care pulmonary unit

Errors in inhaler use related to devices and to inhalation technique among patients with chronic obstructive pulmonary disease in primary health care

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