Aerosol Therapy in Asthma–Why We Are Failing Our Patients and How We Can Do Better

Morton, Robert W.; Elphick, Heather; Craven, Vanessa; Shields, Michael; Kennedy, Lesley

doi:10.3389/fped.2020.00305

Cited by 7 publications

(4 citation statements)

References 89 publications

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“…The intervention was only carried out twice in this study, with direct verbal demonstrations at the first intervention and the second intervention via online video. Repeated education is needed because studies have shown that healthcare professionals' education effectiveness can decrease or even be lost over time and that repeated education can increase the correct use of inhalers in patients on an ongoing basis (Morton et al, 2020). Effective management of COPD therapy consists of 90% education and 10% medication (Xin, Xia, Jiang, Lin, & Li, 2016).…”

Section: Characteristicmentioning

confidence: 99%

The effect of repeated education using live demonstrations and videos of how to use inhalation drugs on quality of life for COPD patients

Sauriasari

Madani

Rozaliyani

et al. 2021

Heliyon

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Repeated education regarding the proper use of inhalers can reduce the error rate in inhaler-using patients and improve COPD patients’ quality of life. This study investigates the effect of repeated education on the quality of life of COPD patients during the pandemic of COVID-19 from February to June 2020. Repeated education is provided using direct demonstrations to patients through educational media in the form of short videos made by the researchers for each inhaler type. This is a pre-experimental study design which was carried out prospectively at Grha Permata Ibu Hospital, Depok. The quality of life of 22 subjects was examined using the COPD assessment test (CAT) questionnaire. Each patient was given a direct verbal demonstration of the appropriate use of the inhaler. One month later, each patient was provided further education using less than 2 min of video sent to them online via the WhatsApp application. Final quality-of-life examination and assessment of inhaler technique were carried out three months after the initial examination. Assessment of proper inhaler technique was carried out using a specific checklist regarding the use of inhaler translated by the researcher. Before and after delivery of repeated education, the mean CAT score showed a decrease of two points, i.e., 12.8 ± 1.3 and 10.8 ± 2.0, respectively. This indicated that quality of life of the patients had significant improvement. However, as many as 63.6% of patients still made mistakes in using inhaler even though they had been educated. For DPI-type inhalers, mistake mostly happened at step “breath out gently, away from inhaler”. For pMDI-type inhalers, mistake mostly happened at step “while holding breath, remove inhaler from mouth”. It can be concluded that repeated education regarding proper inhaler technique with direct demonstrations and further maintained by videos can improve the quality of life in COPD patients.

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Section: Characteristicmentioning

confidence: 99%

The effect of repeated education using live demonstrations and videos of how to use inhalation drugs on quality of life for COPD patients

Sauriasari

Madani

Rozaliyani

et al. 2021

Heliyon

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“…This problem has been recently addressed in the adult population. Morton et al 9 pointed out that many patients with history of asthma are managed by nonasthma specialists who, themselves, may not know how to use an inhaler device and consequently, do not know how to teach IT correctly. Additionally, Plaza et al 10 performed a systematic review in which they analyzed healthcare professionals' IT knowledge: only 15.5% performed IT correctly, with a downward trend over time during the study period.…”

Section: Introductionmentioning

confidence: 99%

Inhaler technique in a pediatric emergency department: Impact of an education intervention among healthcare professionals

Blanco

Revenga

García

et al. 2022

Pediatric Pulmonology

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Background: Inhaler technique (IT) knowledge among healthcare providers is poor.The aim was to improve Pediatric Emergency Department (PED) healthcare providers' IT technique by carrying out an education intervention and sustain it for 6 months.Methods: Open-label, quasi-experimental, prospective, and unicentric study.Healthcare professionals working at the PED were enrolled. The study was developed in three phases: baseline evaluation and education intervention (P1) and reevaluation 1 month (P2) and 6 months (P3) after the education intervention.Participants fulfilled an eight-question theoretical test. Practical skills were evaluated by demonstrating IT in all three phases. The education intervention consisted in a verbal explanation of IT followed by a demonstration of IT with metered-dose inhaler using a mannequin.Results: A total of 84 healthcare providers (medical residents, nurses, and nursing assistants) were involved. In the theoretical questionnaire, the mean score at baseline was 4.4/8 (SD 1.7) improving to 6.3/8 (SD 1.2) in P2 and 6.47/8 (SD 1.1) in P3. In the IT evaluation for children <7 years old, the score improved from 5.7/7 (SD 1.3) to 6.5/7 in P2 and 6.7/7 in P3 (p < 0.001). For children >7 years old, the mean score of IT at baseline was 3.1/10 (SD 4), which improved to 7.4/10 (SD 3) and 8.2/ 10 in P2 and P3, respectively (p < 0.001). Only professional category influenced results at baseline. Conclusion:Healthcare providers' theoretical knowledge and practical skills on IT are low. The education intervention performed is a useful strategy to ameliorate IT among healthcare providers.

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“…Indeed, we have integrated the use of vDOT within our regional difficult asthma service care pathway [ 3 ]. The results from an audit on the implementation of the vDOT programme into routine practice has shown a dramatic reduction in the number of children who require medication escalation to biological medications, i.e.…”

mentioning

confidence: 99%

“…vDOT has been used within our difficult-to-treat asthma care pathway: 1) to ensure a period of optimised care has been delivered (with correct inhaler technique and regular medication use/adherence) [ 3 , 4 ]; 2) to enable the asthma nurses to support children and parents who are having difficulty mastering the correct use of an inhaler (the asthma nurses are able to view uploaded videos and provide day-to-day support to enable the child to develop correct inhaler technique over a few days and weeks via the vDOT platform); 3) to support the exhaled nitric oxide fraction ( F ENO ) suppression test [ 5 ]; and importantly, 4) to monitor adherence and nasal spray technique in children requiring allergic rhinitis treatment. When a child who is not enrolled for vDOT attends the asthma clinic and has an elevated F ENO , it is difficult to know whether the child needs additional steroid therapy or simply to start taking the current prescribed inhaled corticosteroid correctly.…”

mentioning

confidence: 99%

Mobile video directly observed therapy can be used to improve at-home inhaler technique in children with asthma

Shields

McElnay

2021

ERJ Open Res

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We were very pleased to read the article “Comparison of inhalation technique with the Diskus and Autohaler in asthmatic children at home”, recently published in ERJ Open Research [1]. In that paper, the authors describe using video Directly Observed Therapy (vDOT) to detect children's errors when using their inhalers at home. This is very important, and clearly shows that paediatricians and asthma specialists can wrongly assume that if a child can demonstrate correct inhaler technique in the clinic, they will continue to use correct inhaler technique when at home. The authors also report that errors were more frequent when the dry-powder Diskhaler was compared with the Autohaler.

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Aerosol Therapy in Asthma–Why We Are Failing Our Patients and How We Can Do Better

Cited by 7 publications

References 89 publications

The effect of repeated education using live demonstrations and videos of how to use inhalation drugs on quality of life for COPD patients

The effect of repeated education using live demonstrations and videos of how to use inhalation drugs on quality of life for COPD patients

Inhaler technique in a pediatric emergency department: Impact of an education intervention among healthcare professionals

Mobile video directly observed therapy can be used to improve at-home inhaler technique in children with asthma

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