Factors related to the incorrect use of inhalers by asthma patients

Dalcin, Paulo de Tarso Roth; Grutcki, Denis Maltz; Laporte, P; Lima, Paula Borges de; Menegotto, Samuel Millán; Pereira, Rosemary Ricarda Petrik

doi:10.1590/s1806-37132014000100003

Cited by 36 publications

(42 citation statements)

References 12 publications

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“…This finding is consistent with those of the present study, because that was the second most common error made by our patients. Dalcin et al 24 found that the patients who used MDIs made more errors than did those who used other types of inhalers, a finding that is also consistent with those of the present study.…”

Section: Discussionsupporting

confidence: 92%

“…Our findings corroborate those of other studies. 9 23 24 The inability to hold their breath for more than 10 s after inhalation was the major difficulty that our patients encountered during MDI and DPI use (83% and 75%, respectively). Manzella et al 12 assessed inhaler technique and reported that 69% of the patients studied did not hold their breath for at least 10 s. A review compiling the results of 12 studies (including 955 patients) identified the most common errors made by patients using inhaler devices, less than 10 s of breath-holding after inhalation having been observed in 26%.…”

Section: Discussionmentioning

confidence: 95%

“…Dalcin et al 24 and Souza et al 29 used checklists or forms in order to determine whether patients were using their inhalers correctly at work. Souza et al 29 found that 54.5% of the patients who used DPIs did not exhale properly before inhaling the medication.…”

Section: Discussionmentioning

confidence: 99%

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Validation of scores of use of inhalation devices: valoration of errors

Zambelli-Simões

Martins

Possari³

et al. 2015

J. bras. pneumol.

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Objective: To validate two scores quantifying the ability of patients to use metered dose inhalers (MDIs) or dry powder inhalers (DPIs); to identify the most common errors made during their use; and to identify the patients in need of an educational program for the use of these devices. Methods: This study was conducted in three phases: validation of the reliability of the inhaler technique scores; validation of the contents of the two scores using a convenience sample; and testing for criterion validation and discriminant validation of these instruments in patients who met the inclusion criteria. Results: The convenience sample comprised 16 patients. Interobserver disagreement was found in 19% and 25% of the DPI and MDI scores, respectively. After expert analysis on the subject, the scores were modified and were applied in 72 patients. The most relevant difficulty encountered during the use of both types of devices was the maintenance of total lung capacity after a deep inhalation. The degree of correlation of the scores by observer was 0.97 (p < 0.0001). There was good interobserver agreement in the classification of patients as able/not able to use a DPI (50%/50% and 52%/58%; p < 0.01) and an MDI (49%/51% and 54%/46%; p < 0.05). Conclusions: The validated scores allow the identification and correction of inhaler technique errors during consultations and, as a result, improvement in the management of inhalation devices.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

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Validation of scores of use of inhalation devices: valoration of errors

Zambelli-Simões

Martins

Possari³

et al. 2015

J. bras. pneumol.

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“…In Jordan, one study showed that 71% of asthmatic patients poorly controlled . One prominent reason of poor asthma control is the poor inhaler technique, since by performing incorrect inhaler technique substantial reduction in lung deposition of the drug, and as consequence reduction in the effectiveness of the treatment and control . In our study, there is significant improvement in the level of control after education ( P = 0.000).…”

Section: Discussionsupporting

confidence: 47%

The impact of the clinical pharmacist on the use of inhalers among asthmatic patients in Alkarak region in the South of Jordan

Alnawayseh

Naddaf

Taybeh

2020

J Pharm Health Serv Res

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ObjectivesThe main aims of the study were to highlight the impact of clinical pharmacist in patient education on the correct use of inhalers, and its consequences on medication adherence, asthma control and clinical outcomes. Methods Pre-post-interventional study was conducted over two patient visits in Jordan at Alkarak Governmental Hospital. Inhaler technique evaluation was assessed at first and second visits. All patients received inhaler technique counselling service prior to second visit. Patient adherence was assessed using MMAS-8, and asthma control was assessed by spirometry and ATAQ scale. Key findings Complete data were available for 100 patients, 52% women, median age 45 (range 18-60) years and median duration of diagnosis 20 (range 2-55) years. Ninetysix per cent of patients (n = 96) were previously educated about the correct use of inhalers by different healthcare professionals' specialty. There was a statistically significant improvement in the correct handling of inhalers after patient re-education (P = 0.000). There also was a significant improvement in the level of control (from 7% (n = 7) to 90% (n = 90) of participants had high disease control) and adherence (from 6% (n = 6) to 12% (n = 12) of participants had high adherence rate) after education (P = 0.000 and P = 0.000 respectively). Significant number of asthmatic patients uses inhalers incorrectly despite the previous education on the correct inhaler technique. Incorrect use of inhalers is associated with negative outcomes. In this study, the result showed that incorrect handling of MDIs was significantly associated with frequent emergency department (ED) visits and hospitalizations (P = 0.031, P = 0.039) respectively. Conclusions The researchers concluded that effective educational intervention to the patients along with reassessment of inhaler technique and re-education by a well-trained clinical pharmacist gave positive impressive outcomes.

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“…[1][2][3] A faulty inhaler technique incapacitates the patient from delivering adequate amount of medications to airways, leading to a low drug dose Improper inhaler technique has been attributed to various factors including age of the patient, education status, socioeconomic class, quality of training imparted, type of device used etc. [4][5][6][7][8] Presence of comorbidities including obesity, heart disease, cognitive impairment or neuropathy etc. also were found to be associated with improper inhaler use.…”

Section: Introductionmentioning

confidence: 99%

Role of educational intervention with practical demonstration in improving inhaler technique

et al. 2019

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Background: Chronic respiratory diseases are among the leading causes of morbidity and mortality worldwide with chronic obstructive pulmonary disease (COPD) and asthma being the most common. There is under-utilization of the basic tools of inhalation therapy technique(s) in their management. Implementation of a personalized educational and demonstrational intervention by the attending physician during regular follow-up visits of these patients will substantially improve the treatment outcome.Methods: This prospective interventional study was conducted on 239 diagnosed cases of asthma and COPD. Inhaler technique was assessed in accordance to standard checklist and errors were corrected by a practical demonstration. A follow-up assessment was conducted for the same after 2 weeks. Data thus collected was evaluated.Results: Out of 239 patients, 47.6% (n=114) reported for follow-up assessment. Average reporting time for follow-up assessment was 27.4 days. Amongst them, an improvement of at least one step was found in 86.8% (n= 99) and about 28% (n=32) patients performed all steps correctly. Average number of steps improved was 2.1.Conclusions: Majority of the patients showed an improvement in the inhaler technique during follow-up assessment after an educational intervention and practical demonstration. Near perfection was achieved by about more than quarter of the patients. Regular practical demonstration of the inhalation technique during subsequent follow-up sessions unequivocally improves results.

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Factors related to the incorrect use of inhalers by asthma patients

Cited by 36 publications

References 12 publications

Validation of scores of use of inhalation devices: valoration of errors

Validation of scores of use of inhalation devices: valoration of errors

The impact of the clinical pharmacist on the use of inhalers among asthmatic patients in Alkarak region in the South of Jordan

Role of educational intervention with practical demonstration in improving inhaler technique

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