Evaluation of inhalation technique in patients using a dry powder device (DPI) at chest clinic in Dhulikhel Hospital – Kathmandu University Hospital, and the effect of patient education on it

Shrestha, Smriti; Shrestha, Sujita; Baral, Maun Ranjan; Bhandari, Sambhawana; Chand, Swati; Tamrakar, Rajendra; Mehta, Ram Kumar; Vaidya, Nirish; Prajapati, Bijaya Krishna; Shrestha, Satya; Pradhan, Sumita; Dhakal, Prasesh

doi:10.7861/clinmedicine.19-3s-s64

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…However, only 4.3% of COPD patients of this study used the inhaler correctly whereas almost all (95.7%) used inhaler incorrectly. This finding is almost consistent to the finding of studies done by Poudel et al [ 24 ] and Shrestha et al [ 25 ] which showed 5.7% and 11.4% respectively of correct inhaler users. Similar findings have also been reported in other studies conducted in Nepal [ 26 – 28 ].…”

Section: Discussionsupporting

confidence: 93%

Effect of self-management intervention on patients with chronic obstructive pulmonary diseases, Chitwan, Nepal

Sharma,

Subba,

Poudyal

et al. 2024

PLoS ONE

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Background Self-management skills are important for patients with Chronic Obstructive Pulmonary Disease (COPD) who are responsible for their day to day care. Poor self-management behaviours have a significant influence on symptoms, functional impairments and quality of life. Evidence has shown that self-management interventions support patients to respond to changing symptoms and thereby make appropriate decisions regarding their self-management. Objective This study aimed to find out the effect of self-management interventions in patients with COPD in terms of self-management practice, inhaler practice, COPD symptoms burden, functional ability, self-perceived dyspnoea and emotional symptoms. Methods Quasi-experimental pre-test post-test design was carried out among patients with COPD attending respiratory units of Chitwan Medical College Teaching Hospital (CMC-TH), Nepal. Convenience sampling technique was used to select the 70 patients with COPD for the study. Baseline data was collected from the participants using (i) Semi-structured interview schedule for socio-demographic and clinical variables, (ii) COPD Self-Management Practice Questionnaire, (iii) Borg Dyspnoea Scale, and (iv) Six Minute Walking Distance (6MWD) Test (v) Pulmonary Function Test (PFT) and (vi) Observation Checklist. Self-management Intervention given was 2 ½ hour sessions per week for 6 weeks along with information booklets distribution. Participants were re-evaluated after 3 months of intervention using same tools. Data analysis was performed using IBMSPSS version 20.0 for window. Wilcoxon signed-rank test was performed to find the effectiveness of the self-management interventions on outcome parameters. Results Self-management interventions (2 ½ hour session per week for 6 weeks) elicited a statistically significant change on self-management practice (z = -7.215, p<0.001), inhaler practice (DPI practice z = -6.731, p<0.001, MDI practice, z = -1.816, p = 0.005), functional ability (z = -4.243, p<0.001), self-perceived dyspnoea (z = -4.443, p<0.001), COPD symptom burden (z = -7.009, p<0.001) and emotional symptoms (depression, z = -6.856, p<0.001, anxiety, z = -6.675, p<0.001) of patients with COPD. Conclusions Self-management intervention acts as powerful equipment to improve self-management practice, COPD symptoms burden, functional ability, self-perceived dyspnoea and emotional symptoms of patients with COPD. Hence, clinician and policy maker need to plan and intervene the rehabilitation program for the patients with COPD to enhance the effectiveness of therapy, self-management practice and general longevity.

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Section: Discussionsupporting

confidence: 93%

Effect of self-management intervention on patients with chronic obstructive pulmonary diseases, Chitwan, Nepal

Sharma,

Subba,

Poudyal

et al. 2024

PLoS ONE

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“…A study done by Shrestha et al, also reported similar findings where they found that the most frequent incorrect step performed was breathing out slowly followed by failure to hold breath after inhalation. 24 In this study it was found that patients who were using MDI for more than a year had good inhaler technique compared to patients using the inhaler for less than a year as shown in Figure 2. This observation could be explained by the greater number of follow up visits completed by patients who had a longer duration of therapy.…”

Section: Discussionmentioning

confidence: 67%

“…11 In many studies done in the past by various authors whose aim was to assess inhaler technique found out that majority of patients misused their inhalers. [12][13][14][15][16][17][18][19][20][21][22][23][24] To reduce the impact of chronic respiratory diseases one of the solutions is to reinforce correct technique of use of inhaler devices. Therefore, the aim of this study was to find out the lacunae in the technique of use of inhaler device in patients with respiratory diseases so that better patient education interventions can be formulated in future.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the technique of using MDI and DPI in patients with respiratory disease

Rucha¹,

K³

et al. 2021

IJIRM

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Inhalation therapy plays a major role in treatment of respiratory diseases. Correct inhalation technique is crucial for effective clinical outcomes. The aim of this study was to evaluate and analyse technique of use of Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI) in patients with respiratory disease. This observational study was conducted at pulmonary outpatient department of a tertiary care hospital. 30 patients were enrolled using convenience sampling. Participants’ demographic and disease specific data was recorded. Participants were asked to use their inhaler just as they would at home. The technique of device use was observed and recorded using inhaler specific checklists. Data collected was analyzed using descriptive statistics. Out of 30 patients 26 were using MDI, 23 of which (92%) performed at least 1 error. Among 4 patients using DPI, 3 (75%) performed at least 1 error. Patients using MDI for more than 1 year performed less errors compared to those who had been using MDI for less than 1 year, however the difference observed was not significant (n=26, p= 0.304). 29 patients (96%) received education about inhaler device use. The most common incorrectly performed steps were “complete exhalation” and “breath hold.” 92% of MDI and 75% of DPI users made at least one error during the inhalation maneuver despite majority being educated about inhaler technique. The most frequently performed incorrect steps for MDI and DPI were “Complete exhalation” and “Breath hold”.

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Impact of Pharmacist-Led Intervention on Adherence to Inhalers, Inhalation Technique, and Disease Control Among Asthma/COPD Patients in a Resource Limited Center: An Interventional Study

Bhattarai,

Shakya,

Bista

2024

PPA

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Evaluation of inhalation technique in patients using a dry powder device (DPI) at chest clinic in Dhulikhel Hospital – Kathmandu University Hospital, and the effect of patient education on it

Cited by 3 publications

References 10 publications

Effect of self-management intervention on patients with chronic obstructive pulmonary diseases, Chitwan, Nepal

Effect of self-management intervention on patients with chronic obstructive pulmonary diseases, Chitwan, Nepal

Evaluating the technique of using MDI and DPI in patients with respiratory disease

Impact of Pharmacist-Led Intervention on Adherence to Inhalers, Inhalation Technique, and Disease Control Among Asthma/COPD Patients in a Resource Limited Center: An Interventional Study

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