Eficacia de una intervención educativa breve sobre el correcto uso de los inhaladores en la prevención de agudizaciones en pacientes con enfermedad pulmonar obstructiva crónica

Ibán, M Martínez; Porcel, Carlos; Rodríguez, Lidia; Rodríguez, Alcedo; Pérez, Paz; Álvarez, L. Arboleya

doi:10.1016/j.semerg.2018.04.009

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…В ходе настоящего исследования показано, что женский пол, наличие предшествующего инструктажа, а также использование одновременно нескольких ингаляторов разного типа существенно влияют на число ошибок при выполнении ингаляции. Ухудшение техники ингаляций при использовании нескольких ингаляторов одновременно [16], а также влияние предшествующего обучения медицинскими работниками на технику ингаляций подтверждают многие исследования [16,22,26,28,29].…”

Section: Discussionunclassified

“…Однако многие факторы, которые не оказывали существенного влияния на технику ингаляций в рамках данного исследования, оказались значимыми по результатам других работ. Ряд исследований выявил связь ошибок в ингаляционной технике с уровнем образования [18,22,30], социальным статусом, числом сопутствующих заболеваний (2 и более) [18], наличием сердечно-сосудистой патологии в анамнезе [30], длительностью использования ингалятора [28,31]. Согласно некоторым исследованиям пациенты с ХОБЛ совершают больше ошибок, чем пациенты с БА [21,22].…”

Section: Discussionunclassified

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Assessment of inhalation technique in patients with bronchial asthma and chronic obstructive pulmonary disease

Trushenko

Stoliarevich

Andriukov

et al. 2023

Terapevticheskii arkhiv

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Abstract Aim. Investigate inhalation techniques using different inhalers types and their effect on the course of disease. Materials and methods. This cross-sectional study included 110 patients with asthma, chronic obstructive pulmonary disease using the inhaler at least one month. Inhaler errors performed during demonstration were evaluated for each patient and entered in the check-lists. We also collected information about co-morbidities, education, mMRC dyspnea score, rate of exacerbations, and performed spirometry. Results. 80.9% of patients used metered-dose inhaler, 20.9% single-dose and 21.8% multiple-dose dry powder inhaler, 22.7% soft-mist inhaler. Inhaler errors were made by 80.9% patients. The mean number of mistakes in metered-dose inhaler use was 21.6, single-dose powder inhaler 1.51.3, multiple-dose dry powder inhaler 1.251.4, soft-mist inhaler 0.680.7 (р=0.003). Age, diagnosis, duration of disease, education level, inhalers usage by relatives have no influence on the inhalation technique. A number of errors was related to female gender (р=0.007) and usage of more than 2 inhalers (r=0.3, p=0.002), previous instruction about inhalation technique (r=0.3, p=0.001). On the other hand, there were correlations between the number of errors and degree of bronchial obstruction, asthma control, severity of dyspnea by mMRC score, exacerbation rate. Conclusion. Patients with bronchoobstructive diseases perform many inhaler errors, that substantially influences the severity and course of asthma and chronic obstructive pulmonary disease.

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Section: Discussionunclassified

Assessment of inhalation technique in patients with bronchial asthma and chronic obstructive pulmonary disease

Trushenko

Stoliarevich

Andriukov

et al. 2023

Terapevticheskii arkhiv

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“…Similar results were obtained in the present study by questioning GPs. The IT must also be reviewed periodically in order to be effective ( Kim et al, 2021 ; Dekhuijzen et al, 2022 ; Global Iniciative for COPD, 2022 ), as a relationship between regular instruction and adherence has been observed ( Martínez Ibán et al, 2019 ; Ahn et al, 2020 ; Efil et al, 2020 ), with an improvement in the quality of life ( Martínez Ibán et al, 2019 ; Efil et al, 2020 ; Luley et al, 2020 ; Lindh et al, 2022 ) and a reduction in the need for hospital admission of up to 80% ( Martínez Ibán et al, 2019 ; Efil et al, 2020 ). Thus, the professionals considered that the IT should be checked periodically, although they did not agree on how often it should be checked.…”

Section: Discussionmentioning

confidence: 99%

“…A poor IT leads to a reduction of its beneficial effect, lower symptom control, and therefore, poor COPD control ( Padmanabhan et al, 2019 ; Vila Jato, 2020 ; Dekhuijzen et al, 2022 ). It may also be associated with an increase in the number of emergency room visits, hospitalizations, or the use of antibiotic and corticosteroid treatments, ultimately increasing the cost of COPD management, increasing adverse reactions, and limiting therapeutic alternatives ( Martínez Ibán et al, 2019 ; Efil et al, 2020 ; Vila Jato, 2020 ; Dekhuijzen et al, 2022 ). The performance of the correct IT has been related, in this study as well, to a better FEV1, perhaps because correct performance allows for better FEV1, potentially slowing down functional deterioration, and it then improves the technique because there are steps that are related to good pulmonary function, such as deep inhalation of the aerosol ( Melani et al, 2011 ; Padmanabhan et al, 2019 ; Efil et al, 2020 ; Vila Jato, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of an educational intervention about inhalation technique in healthcare professionals in primary care: a cluster randomized trial

Vázquez-González,

Leiva-Fernández,

Cotta-Luque

et al. 2023

Front. Pharmacol.

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Background: Incorrect inhalation technique (IT) is an important issue for chronic obstructive pulmonary disease (COPD) patients and healthcare professionals. Studies in which counseling is carried out with healthcare professionals beforehand so that they can properly educate their patients are required. The objective of the present trial is to assess the improvement in the performance of the IT in subjects with COPD and prescribed inhaled therapy after the implementation of an educational intervention conducted by their general practitioners.Methods: A cluster randomized clinical trial was conducted. A total of 286 COPD patients received scheduled inhalation therapy from 27 general practices in seven primary care centers. A teach-back educational intervention was implemented for both healthcare professionals and patients. The primary outcome of this study was the performance of the correct inhalation technique. It is considered a good technique if all steps in the inhalation data sheet are correctly performed. The secondary outcomes were assessed using forced spirometry, the basal dyspnea index, the Medical Research Council dyspnea scale, St George’s Respiratory Questionnaire (SGRQ), and EuroQoL5D-5L for health-related quality of life. A one-year follow-up was conducted using an intention-to-treat analysis.Results: After the intervention, incorrect IT was observed in 92% of professionals and patients, with rates reaching 50% and 69.2%, respectively. The effectiveness in patients was significant, with a number needed to treat of 2.14 (95% CI 1.79–2.66). Factors related to correct IT in patients included the type of intervention, length of intervention (>25 min), good pulmonary function, age (youngest <=65, oldest >83), and less limitation of activity due to dyspnea. There was no relation with the cluster.Conclusion: This study shows the effectiveness of direct inhaler technique training provided by a trained professional on an appropriate timescale (for example, a specific consultation for medication reviews), aiming to help subjects improve their performance using the teach-back method. This could be an encouraging intervention to improve medication adherence and health promotion in people with COPD.Clinical Trial Registration:clinicaltrials.gov, identifier ISRCTN93725230.

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Self-management interventions for people with chronic obstructive pulmonary disease

Schrijver

Lenferink

Brusse‐Keizer

et al. 2022

Cochrane Database of Systematic Reviews

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Eficacia de una intervención educativa breve sobre el correcto uso de los inhaladores en la prevención de agudizaciones en pacientes con enfermedad pulmonar obstructiva crónica

Cited by 3 publications

References 16 publications

Assessment of inhalation technique in patients with bronchial asthma and chronic obstructive pulmonary disease

Assessment of inhalation technique in patients with bronchial asthma and chronic obstructive pulmonary disease

Effectiveness of an educational intervention about inhalation technique in healthcare professionals in primary care: a cluster randomized trial

Self-management interventions for people with chronic obstructive pulmonary disease

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