Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults

Melani, Andrea S.; Zanchetta, Doriana; Barbato, Natalino; Sestini, Piersante; Cinti, Cristina; Canessa, Piero Aldo; Aiolfi, S; Neri, Margherita

doi:10.1016/s1081-1206(10)61410-x

Cited by 149 publications

(133 citation statements)

References 10 publications

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“…DPIs are widely used in clinical practice; however, a number of studies have shown that many patients don't use inhalers correctly with fi gures for incorrect inhalation technique ranging from four percent to 94 percent 6 with as many as 67 percent misusing their rotahaler 13 . The fi nding of the present study showed that only 37 percent use their inhalers correctly consistent to the fi ndings of various international studies 14,15 .…”

Section: Discussionsupporting

confidence: 91%

Assessment of rotahaler inhalation technique among patients with chronic obstructive pulmonary disease in a teaching hospital of Nepal

Sapkota

Amatya

2017

J. Kathmandu Med. Coll.

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Background: Inhalation mode of drug delivery is the mainstay treatment for chronic obstructive pulmonary disease, however; incorrect technique prevents patients from receiving maximal therapeutic benefi ts. Objectives: To assess usage technique of rotahaler among patients with chronic obstructive pulmonary disease and identify factors affecting its performance. Methods: Descriptive cross sectional study was conducted to assess rotahaler (single unit dose dry powder inhaler) inhalation technique among patients with chronic obstructive pulmonary disease in Kathmandu University Teaching Hospital. The study population consisted of 100 respondents using rotahaler for at least one year. Data collection was done by standard checklist, semi structured questionnaire via observation and interview methods respectively. Results: Correct inhalation technique was found in 37% of total respondents. Nearly two out of three respondents (61%) failed to breathe out deeply before inhaling. Majority of the respondents (59%) failed to hold breath for at least 10 second and 25% were unable to breathe in deeply. Age, occupation, source of inhalation instruction and re-demonstration of the technique were found to be signifi cantly associated with the correct inhalation technique (p <0.05). Conclusion: More than half of the respondents had incorrect inhalation technique, so health education program targeting the common identifi ed errors should be carried out. Arrangements should be made for regular involvement of pharmacist in teaching and re-demonstration to ensure good inhaler technique. This would ultimately lead to a greater clinical response and improved patient compliance.

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Section: Discussionsupporting

confidence: 91%

Assessment of rotahaler inhalation technique among patients with chronic obstructive pulmonary disease in a teaching hospital of Nepal

Sapkota

Amatya

2017

J. Kathmandu Med. Coll.

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“…The proportions of people with asthma or COPD using inhaler devices incorrectly were similar for MDIs (24%), Turbuhaler (23%), and Diskus (24%). 10 This suggests the need to investigate further optimization of all device users' technique.…”

Section: Introductionmentioning

confidence: 99%

Inhaler Technique Training and Health-Care Professionals: Effective Long-Term Solution for a Current Problem

et al. 2014

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INTRODUCTION:The aims of this study were (1) to assess the ability of a range of health-care professionals (HCPs: specialists [physicians specializing in management of airways disease], general practitioners, pharmacists, pharmacist assistants, nurses, and respiratory therapists) in Jordan to demonstrate the correct use of some commonly used inhalers using standardized checklists, with highest scores indicating optimal use, and (2)

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“…Patients with COPD are often prescribed several inhalers, including pressurized metered dose inhalers (MDIs) and breath actuated dry powder inhalers (DPIs); each requiring very different inhalation techniques. Poor inhaler technique is common and significantly limits drug delivery to the lungs 9 . Correct administration of these inhaled medications is very important for successful management of COPD.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of a Literacy-Sensitive Self-Management Intervention for Chronic Obstructive Pulmonary Disease Patients

et al. 2011

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BACKGROUND: Low literacy skills are common and associated with a variety of poor health outcomes. This may be particularly important in patients with chronic illnesses such as chronic obstructive pulmonary disease (COPD) that require appropriate inhaler technique to maintain quality of life and avoid exacerbations. OBJECTIVE: To explore the impact of a literacy-sensitive self-management intervention on inhaler technique scores in COPD patients and to determine if effects differ by literacy. DESIGN: Randomized controlled trial. PARTICIPANTS: Ninety-nine patients with COPD. INTERVENTION: Patients were randomly assigned to a one-on-one self-management educational intervention or usual care. The intervention focused on inhaler technique, smoking cessation, and using a COPD action plan. MAIN MEASURES: At baseline, an inhaler technique assessment, literacy assessment, health-related quality of life questionnaires, and pulmonary function tests were completed. Inhaler technique was re-evaluated after two to eight weeks. KEY RESULTS: Mean age 63, 65% female, 69% Caucasian, moderate COPD severity on average, 36% with low literacy, moderately impaired health-related quality of life, and similar baseline metered dose inhaler technique scores. Patients in the intervention group had greater mean improvement from baseline in metered dose inhaler technique score compared to those in the usual care group (difference in mean change 2.1, 95% CI 1.1, 3.0). The patients in the intervention group also had greater mean improvements in metered dose inhaler technique score than those in the usual care group whether they had low health literacy (difference in mean change 2.8, 95% CI 0.6, 4.9) or higher health literacy (1.8, 95% CI 0.7, 2.9).CONCLUSIONS: A literacy-sensitive self-management intervention can lead to improvements in inhaler technique, with benefits for patients with both low and higher health literacy.KEY WORDS: COPD; inhaler technique; health literacy; selfmanagement; randomized controlled trial.

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Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults

Cited by 149 publications

References 10 publications

Assessment of rotahaler inhalation technique among patients with chronic obstructive pulmonary disease in a teaching hospital of Nepal

Assessment of rotahaler inhalation technique among patients with chronic obstructive pulmonary disease in a teaching hospital of Nepal

Inhaler Technique Training and Health-Care Professionals: Effective Long-Term Solution for a Current Problem

A Randomized Controlled Trial of a Literacy-Sensitive Self-Management Intervention for Chronic Obstructive Pulmonary Disease Patients

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