Influence of Gender on Inhaler Technique

Ocaklı, Birsen; Özmen, İpek; Tunçay, Eylem; Güngör, Sinem; Ozalp, Aylin; Yasin, Yeşim; Adıgüzel, Nalan; Güngör, Gökay; Karakurt, Zühal

doi:10.4187/respcare.06917

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…In some studies, the female (24) gender has been associated with a high risk of error of use of inhalers and with a high proportion of males that correctly use the inhales and who have a correct inhalation technique . However, other studies have (3) revealed a weaker performance among men concerning the correct manipulation of inhalers, while other studies did not identify any difference between the two genders (6,8,23).…”

Section: Original Papersmentioning

confidence: 79%

The Impact of Technical Skills and Education on Exacerbations, Adherence to Treatment and the Choice of Inhaler Device in Patients with COPD

Bivolaru¹,

Constantin²

2023

Internal Medicine

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Introduction. The largest challenge for patients with COPD is the correct use of inhaler devices. In COPD, inhalation therapy has a key role in symptom control, reducing the exacerbation rate, hospitalization and improving the quality of life. Choosing the active substance(s) administered by inhaler devices is an easy task because of the Gold guideline recommendations, but, when it comes to choosing the inhaler device, it is much more difficult to get recommendations. Methods. Our analysis included 200 subjects divided into two groups and its objective was the identification of some mechanisms that connect education, exacerbation and adherence to treatment, placed in the context of measuring technical skills and patients` preference for a particular inhaler device. All subjects included in the analysis were subjected to a technical skills test that included a set of 10 questions with a 30-minute solving time. The subjects in the working group were put in the position of deciding factor for the choice of an inhaler device, and implicitly for the treatment they would follow during monitoring. Results. In both groups, the lowest treatment dropout rate at T12 was recorded among those with higher levels of education, while those with poor education levels recorded very high dropout rates. In both groups we noticed that, as the level of education increased, technical skills were also increasingly better. Both in the control group and in the working group, dropout subjects at T12 had significantly lower technical skills compared to subjects who did not drop out. The level of technical skills was significantly lower in both groups in subjects with exacerbations. Statistical analysis proved the relationship between the low level of technical skills and exacerbation. The subjects with lower technical skills proved to be more prone to dropout of inhaler therapy as well. The proportion of subjects with exacerbations in the control group was significantly higher than the proportion of those with exacerbations in the work group. The proportion of subjects with exacerbations in the control group was significantly higher than the proportion of those with exacerbations in the work group. Conclusions. The authors consider that the involvement of the patient in choosing the inhaler device had a positive impact on disease control and reducing the rate of exacerbations.

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Section: Original Papersmentioning

confidence: 79%

The Impact of Technical Skills and Education on Exacerbations, Adherence to Treatment and the Choice of Inhaler Device in Patients with COPD

Bivolaru¹,

Constantin²

2023

Internal Medicine

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“…Gender is another disputed characteristic [10]. In most studies, female gender correlated with worse inhaler use, although not all studies confirmed this gender-based difference [91, 92]. Ocakli et al [92] demonstrated that women were often more aware of subjective inhaler use problems.…”

Section: Resultsmentioning

confidence: 99%

“…In most studies, female gender correlated with worse inhaler use, although not all studies confirmed this gender-based difference [91,92]. Ocakli et al [92] demonstrated that women were often more aware of subjective inhaler use problems. This characteristic does not require a specific assessment method.…”

Section: Gendermentioning

confidence: 99%

Patient Characteristics to Consider When Selecting an Inhaler for the Treatment of Chronic Obstructive Pulmonary Disease and Available Assessment Methods: A Narrative Review

Renaud,

Suter,

Grandmaison

2023

Respiration

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Inhaler misuse is common among patients with chronic obstructive pulmonary disease and associated with poor disease control. Many patient characteristics are reported to impact inhaler use, but there are no studies in the literature on the best way to evaluate them. This narrative review aims to identify patient characteristics that influence the correct use of an inhaler and describe the tools available for their assessment. First, we searched four different databases to identify reviews describing patient characteristics reported to impact inhaler use. In a second step, ways to characterize these aspects were searched using the same databases. Fifteen patient characteristics impacting on the use of inhalers were identified. Peak inspiratory flow, dexterity, and cognitive impairment were the most studied characteristics and appeared to have the highest impact on the correct use of inhalers. Notably, peak inspiratory flow can be reliably assessed in clinical practice using the In-Check Dial<sup>®</sup>. Triggering coordination, breath retention, collaboration/consciousness, and muscle strength in the fingers were important characteristics, but insufficient data exist to recommend the use of a specific tool for their assessment in daily practice. Other identified characteristics have a more uncertain impact. A demonstration of inhalation technique by the patient, combined with the measurement of peak inspiratory flow using the In-Check Dial<sup>®</sup>, appears to be an effective strategy to assess the characteristics with the highest impact on the correct use of an inhaler. In the future, “smart” inhalers could also play a decisive role in this area.

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“…In our study patients sociodemographic characteristics like age and sex were not associated with incorrect inhaler using technique, though patients with lower educational attainment and socioeconomic condition reported to have higher rate of critical errors in using inhalers. However, elderly patients as well as female patients using inhalers were reported to face more di culties and make more errors in handling their devices in case of both MDI and DPI compared to their counterparts [13,27]. Besides, patients educational attainment was also reported as a signi cant predictor of inhaler using technique in different studies [28,29].…”

Section: Discussionmentioning

confidence: 99%

Assessment of inhaler using technique among adult asthma patients in Bangladesh: a facility-based cross-sectional study

Rafi¹,

Hasan²,

Mily³

et al. 2022

Preprint

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Background: Inhaler using technique has influences on disease control in patients with bronchial asthma. The objective of this study was to assess the inhaler using technique and factors associated with correct technique among adult asthma patients in northern Bangladesh.Methods: A total 357 asthma patients were recruited from medicine outpatient department of Rajshahi Medical College Hospital (RMCH) from November 2020 to January 2021. All patients were stable and using either metered dose inhaler (MDI) with or without spacer or dry powder inhaler (DPI). Demographic and disease details were collected by direct interviewing of the patients and inhaler using technique were also observed. A preformed checklist was used for marking the activities of the patients. Inhaler using technique was defined as incorrect if there was one or more critical error observed during using the prescribed inhaler. Logistic regression model was used to determine the predictors of incorrect inhaler using technique. Results: Almost 77% of the MDI users, 85% of the MDI with spacer users, and 76% of the DPI users had at least one or more critical error in handling their inhaler devices. Most commonly missed critical steps were breathing in adequately during inhalation (40% in MDI and 39% in DPI users) and holding breath after inhalation (54% in MDI and 77% in DPI users). Patients with lower educational attainment (aOR 4.56, 95% CI 1.13-18.37, p<0.05), middle-income family (aOR 6.44, 95% CI 1.73-24.03, p<0.01), self-reported difficulty of inhaler technique (aOR 3.18, 95% CI 1.58-6.41, p<0.01), seeking care from non-qualified practitioners (aOR 2.86, 95% CI 1.42-5.75, p<0.01) and no demonstration of inhaler technique (aOR 2.07, 95% CI 1.71-3.01, p<0.05) or demonstration from non-qualified practitioners (aOR 2.41, 95% CI 1.79-4.36, p<0.05) had higher chance of incorrect inhaler using technique.Conclusion: Majority of the asthma patients included in our study had one or more critical error in their inhaler using technique especially in patients with lack of inhaler using training. Patient counseling and demonstration of inhaler using technique during prescription might increase the proportion of patients practicing right technique of inhaler.

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Influence of Gender on Inhaler Technique

Cited by 5 publications

References 31 publications

The Impact of Technical Skills and Education on Exacerbations, Adherence to Treatment and the Choice of Inhaler Device in Patients with COPD

The Impact of Technical Skills and Education on Exacerbations, Adherence to Treatment and the Choice of Inhaler Device in Patients with COPD

Patient Characteristics to Consider When Selecting an Inhaler for the Treatment of Chronic Obstructive Pulmonary Disease and Available Assessment Methods: A Narrative Review

Assessment of inhaler using technique among adult asthma patients in Bangladesh: a facility-based cross-sectional study

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