Do Egyptian patients use their inhalers correctly? A checklist auditing for inhalation devices usage techniques

Madkour, Ashraf; Galal, Iman

doi:10.1016/j.ejcdt.2015.01.006

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…Also, Breezhaler showed better inhalation manoeuvre than Aerolizer (90% vs 75% respectively) which is an unexpected result, in basis of device resistance, it could be attributed to different sample size and power of assessment beside the possibility of better patient education on the past which was not recorded by the present study. Diskus showed lower rate of committing at least 1 critical error than Turbohaler in agreement with many other studies, 22,47,58 but they were not significantly different 15 . That was further analysed for essential steps achievements to these inhalers, and found that only 72.41% of patients twisted grip at the base and then back until click is heard during Turbohaler loading, however, 94.29% of patients slided the lever away from the mouthpiece during Diskus loading.…”

Section: Discussionsupporting

confidence: 88%

“…In this study, COPD patients committed both critical and non‐critical errors with their familiar inhalers despite their past‐experience. Therefore, patient past‐experience with inhalers could not exclude further handling errors in agreement with previous studies 23,47,48 . Use of pMDI was associated with a significantly lower rate of correct step achievements than all the DPIs studied as reported by many studies 23,44,48‐51 .…”

Section: Discussionsupporting

confidence: 52%

“…Therefore, patient past-experience with inhalers could not exclude further handling errors in agreement with previous studies. 23,47,48 Use of pMDI was associated with a significantly lower rate of correct step achievements than all the DPIs studied as reported by many studies. 23,44,[48][49][50][51] It is not breath-actuated like DPIs so they need additional patient skills and cooperation which is missing in the majority of the study population being elderly, with low inspiratory capacity and possible comorbidities which make them more likely to have impaired physical skills and poor hand-lung coordination.…”

Section: Discussionmentioning

confidence: 78%

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Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

et al. 2020

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Purpose This study aimed to evaluate handling of six common inhalers and to determine correlations between correct inhaler technique and patient demographics/ clinical variables. Methods A total of 180 chronic obstructive pulmonary disease (COPD) patients were crossed‐over to handle their past‐experienced inhalers among (pMDI, Aerolizer, Handihaler, Breezhaler, Turbohaler, and Diskus) randomly, without receiving verbal or demonstrative instruction (baseline assessment). Inhaler technique was assessed using previously defined checklists. The correct use of the inhaler was then demonstrated and the patient was evaluated for inhaler use again. Demonstration was repeated until a correct technique was achieved. Number of counselling attempts needed to a complete right handling, patient demographics and clinical variables were recorded. Results The mean percentage of total correct steps showed that pMDI is significantly lower than all other inhalers (76.01 ± 12.61 vs 84.18 ± 10.87, 84.60 ± 12.10, 85.91 ± 9.82, 90.63 ± 9.29 and 91 ± 10.22 for Diskus, Turbohaler, Aerolizer, Handihaler and Breezhaler, respectively, at P < .001). Breezhaler showed the lowest percentage of participants with at least 1 critical error (20%) however, pMDI showed the highest percentage (85.19%) at P < .05. Breezhaler showed that the highest percentage of participants achieved a complete right handling after 1st counselling attempt, however, pMDI was the only inhaler included in a 3rd and 4th counselling attempts (5.93% and 0.74%, respectively). Weak and very weak correlations were found between total correct steps and demographics/clinical variables. Conclusions pMDI is not preferable for handling by COPD patients. DPIs vary in ease of use, so that inhaler therapy must be individualised on basis of patient handling assessment with repeated counselling.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 78%

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Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

et al. 2020

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“…The findings of this study were similar to other study which concluded that providing instructions by the prescriber is the most adjustable beneficial tool to decrease poor technique of inhaler use [24].…”

Section: Shammer and Baaysupporting

confidence: 90%

“…In this study, we noticed that the low score of the technique of the inhaler use had a substantial influence on the control of asthma (ACT score) and COPD (CAT) score with p<0.001 for both groups which is compatible with other study [24].…”

Section: Fig 2: Correlation Between Inhaler Technique Score Before Isupporting

confidence: 90%

Assessment of Inhalers Technique Proper Use for Patients With Chronic Respiratory Diseases in Primary and Secondary Clinics in Babylon City

Shammer

Baay

2018

Asian J Pharm Clin Res

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Objective: Although the inhalers are the preferred method of medications delivery, evidences suggest that many patients are unable to use their inhalers effectively due to improper technique so patients must know the right way of their inhaler use. The aim of the study is to assess the patient’s ability to use their inhalers properly, identify the most common error made, assess the benefit of single education session, compare the property of the use between the primary and secondary clinics patients, determine which type of the inhaler devices is associated with more errors, and to identify the association between the inhaler technique and the disease control.Methods: Non-randomized interventional study was done on 100 inhaler users of three inhaler types (metered-dose inhaler [p MDI], Turbuhaler, or Handihaler) for chronic respiratory diseases. Inhaler technique was evaluated by a scoring system before and after single session of training.Results: It had been shown that the current education about inhalers techniques was not sufficient. The response to single session of education was higher with high level of education, urban area, and specialized respiratory center. Better disease control with the better score. After training, the younger patients have higher score.Conclusion: We conclude that we need to stress on the most reported defect, metered-dose inhaler had the lowest mean score; therefore, it needs more training. Furthermore, single class of training can be beneficial but need follow-up to see if this effect can be maintained.

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Impact of training on use of inhalational techniques of different inhaler devices: A single institutional cross sectional observation study

Chawla¹,

Banerjee²,

Yadav³

et al. 2021

Indian Journal of Tuberculosis

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Do Egyptian patients use their inhalers correctly? A checklist auditing for inhalation devices usage techniques

Cited by 9 publications

References 16 publications

Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

Real‐life assessment of chronic obstructive pulmonary disease patient performance with different inhalers

Assessment of Inhalers Technique Proper Use for Patients With Chronic Respiratory Diseases in Primary and Secondary Clinics in Babylon City

Impact of training on use of inhalational techniques of different inhaler devices: A single institutional cross sectional observation study

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