Clinical Characteristics of Asthmatic Patients Prescribed Various β-Agonist Metered-Dose Inhalers at Yamagata University Hospital

Abstract

To determine the prescription characteristics of b-agonist metered-dose inhalers (MDI), we retrospectively investigated all prescriptions containing one ofˆve types of b-agonist MDIs available at Yamagata University Hospital in 1997, as well as patients' characteristics. The total number of asthmatic patients was 225 (age, 11-79, mean, 47.2) in 1997. Fenoterol MDI was prescribed to patients who visited the hospital at regular periods and had more severe asthma. Isoprenaline MDI also was not prescribed forˆrst-time patients. Patients who were prescribed tulobuterol MDI had mild or moderate asthma and some of them were only occasional orˆrst-time visitors. Salbutamol and procaterol MDIs were also prescribed forˆrst-time patients; however, tulobuterol MDI was the most frequently prescribed forˆrst-time patients. Patients prescribed fenoterol and isoprenaline MDIs had adequate knowledge of proper asthma management, because su‹cient information had been provided about the use of MDIs in the past. Patients prescribed tulobuterol MDI should be provided with detailed instructions because they had little knowledge of handling MDIs and selfmanagement of asthma as many of them wereˆrst or intermittent visitors. Patients prescribed salbutamol or procaterol MDIs should be evaluated regarding their past medications and some of them should be instructed regarding the use of the MDI. Although these clinical aspects might be applicable only to our hospital, the same or other prescription patterns will be found in other hospitals and/or by other physicians. Adequate instructions to individual patients who are prescribed a particular b-agonist MDI should be provided by the medical staŠ, especially to outpatients, to reduce hospitalization and death from asthma.

Assessment of Inhalation Technique in Primary Care Asthmatic Patients Using Metered-Dose Inhalers with or without a Spacer

“…25 Respiratory care therapists should be used in the outpatient setting since they are most proficient among all health care providers in the proper use of an MDI. 26 When prescribing an MDI for the first time, patient preference may also be useful for assessing acceptance and compliance with a device.…”