Assistance of family carers for patients with COPD using nebulisers at home: a qualitative study

Abstract

ObjectiveFor many patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD), the assistance of family carers with medicines is vital for optimal treatment outcomes. The aim of this study was to identify the assistance carers provide to patients with COPD using nebuliser-delivered therapy at home, and the problems experienced that may impact on the safety and effectiveness of therapy and contribute to carer burden.MethodsA cross-sectional, qualitative descriptive study was conducted with participants recruited from primary and intermediate care. Home interviews were conducted with 14 carers who assisted a family member with COPD using a nebuliser. Qualitative procedures enabled analysis of nebuliser-related activities and problems experienced by carers.ResultsThe carer sample included 10 female and 4 male carers, with a mean age of 61 years: 11 spouses and 3 daughters. They had assisted patients with use of their nebuliser and associated medications for, on average, 4.5 years. Assistance ranged from taking full responsibility for nebuliser use to providing help with particular aspects only when required. Nebuliser-related activities included assembling and setting up equipment, mixing medicines, operating the device, dismantling and cleaning equipment. Difficulties were described with all aspects of care. Carers reported concerns about medication side effects and the lack of information provided.ConclusionsThe study revealed the vital role of carers in enabling effective therapy. The wide-ranging responsibilities assumed by carers and problems experienced relate to all aspects of COPD management with nebulisers, and have a potential impact on treatment outcomes and carer burden. A systematic approach to addressing carers’ needs and prioritising support would be anticipated to have positive consequences for patients, carers and health services.

Support for Australian carers from community pharmacy: Insight into carer perspectives of a novel service

“…Concerns or issues about managing medication, as evidenced by the extensive literature available on this topic (Alhaddad, Taylor, Robertson, Watman, & Smith, ; Look & Stone, ; Maidment et al, ; Wingham et al, ), was noticeably absent from our data. This was surprising given that pharmacists are well placed to address medication‐related issues.…”

A Systematic Review on KAP of Nebulization Therapy at Home

“…Also, one of the patients reported that he does need somebody to make sure he is doing it properly. 6 Overall, the review showed that there is lack in knowledge about the proper dilution of medication with many study participants.…”

“…The study reported that about 22 participants (n = 50) failed to ensure it prior to filling the drugs. 4 Another study conducted by Alhaddad and colleagues 6 reported that the patient caretaker found it difficult to set the nebulizer at home. This study was conducted among 14 participants in which 8 participants experienced difficulty in setting up and operating the nebulizer.…”

“…This study was conducted among 14 participants in which 8 participants experienced difficulty in setting up and operating the nebulizer. 6 Setting up the breathing tube and ventilator settings have direct effect on the amount of medication that is reaching or dispensed to the patient's lungs. It is suggested that delivery efficiency should be carefully assessed for a given nebulizer/circuit/ventilator combination.…”

Effectiveness of Demonstration Skill on Use of Nebulization Therapy among the Parents of Hospitalized Children

“…Nebulisers prove difficult to use, as they require device assemblies, dosage, diluent often combined, inhaled for a few minutes and then disassembled, cleaned, sanitized and dried [4].…”