Unique location but similar issues: working with health professionals in correctional services to improve inhaler use

Abstract

Background Correct inhaler technique is vital in the management of asthma and chronic obstructive pulmonary disease. However, inhaler misuse is ubiquitous and patients seldom receive effective education on how to use inhalers. Prisoners may have additional contributing factors for inhaler misuse, i.e. low health literacy and intellectual disability. Consequently, health professionals within correctional service facilities have a unique opportunity, and arguably an even more critical role, in the training of inmates in inhaler use. Aim To evaluate correctional services health professionals’ baseline inhaler techniques; to assess the impact of training on inhaler techniques; and to evaluate the impact of the training on service delivery to inmates. Method Nurses working in a correctional services hospital complex were recruited. Their baseline inhaler technique (i.e. prior to training) was assessed using inhaler technique checklists. An education intervention was then delivered, following which participants’ inhaler technique was reassessed. Results A total of 23 nurses participated in the study. At baseline, proportions demonstrating correct technique were 42, 0 and 5% for metered dose inhalers, Turbuhaler and Accuhaler, respectively. Following training, there was a statistically significant increase in the proportion of participants demonstrating correct inhaler techniques (84% (p = 0.008), 84% (p < 0.001) and 90% (p < 0.001)). Conclusions Nurses in correctional care are expected to check inmates’ inhaler techniques as part of clinical care, but were unable to use inhalers correctly and needed training in this regard. Pharmacists are well placed to provide this training.