Mauvaise utilisation des aérosol-doseurs par les asthmatiques

Gayrard, P; Orehek, J

doi:10.1159/000194250

Cited by 28 publications

(5 citation statements)

References 6 publications

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“…15 This leads to increased morbidity and mortality, as well as increased hospitalization, death, and global cost on the health-care system. [15][16][17] Improper techniques include not shaking the inhaler before use, not priming it, not breathing out before actuation of the inhaler, not breathing in while pushing down the canister, failure to hold the breath after inhalation, holding the inhaler with its canister down, not inhaling slowly and deeply and exhaling quickly. 7 Furthermore, old age, 18,19 gender, 20 low education level, 21 disease-specific knowledge, 22 and limited access to primary care 23 were all linked to poor inhaler technique.…”

Section: Introductionmentioning

confidence: 99%

Asthma and COPD Patients’ Perception of Appropriate Metered-Dose Inhaler Technique

et al. 2020

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Objectives: Asthma and chronic obstructive pulmonary disease (COPD) are chronic illnesses of the airways affecting a good number of people in Lebanon and the Middle East. Pressurized metered-dose inhalers (pMDIs) are important drug delivery systems used to treat such pulmonary diseases. Drugs proven to be valuable and effective may fail to act effectively if such inhalers are used incorrectly. The purpose of this study was to assess the technical use of pMDIs by patients with pulmonary diseases presenting to the community pharmacies in Lebanon. Methods: A structured questionnaire was developed to collect data. A total of 601 patients using drugs delivered through pMDIs and presenting to 12 Lebanese community pharmacies were recruited to participate in the research project. The questionnaire items were divided into 3 subscales: subscale 1—assessing the device preparation; subscale 2—investigating the device use; and subscale 3—examining the knowledge and use of spacers. After confirming the reliability and validity of the survey tool, patients’ responses were analyzed and compared according to many variables. Results: Many patients answered inaccurately to questions assessing both the device preparation and use. Around 40% of patients said they do not coordinate the inhalation with pressing the canister down. The mean scores were 1.72 (± 0.73) over 6 and 5.67 (± 1.44) over 7 for subscales 1 and 2, respectively. The mean total score on all questions was 7.39 over 13, with a standard deviation of 1.75. While patients’ age did not impact the results, asthmatic, well-educated, male patients had fewer wrong answers when it comes to preparing and using the device ( P < .01). Conclusions: Our study showed that many patients with asthma and COPD might not be properly using their pMDIs. Appropriate inhaler use is crucial for successful pulmonary disease management. As pMDIs are one of the most difficult devices to use, proper and tailored instructions should be given to patients.

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Section: Introductionmentioning

confidence: 99%

Asthma and COPD Patients’ Perception of Appropriate Metered-Dose Inhaler Technique

et al. 2020

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“…Much interest has been expended on the ability of asthmatic patients to follow the instructions for oral inhalation o f pres surized bronchodilator aerosols [2,5,6]. Even after training, many patients are un able to follow the instructions completely.…”

Section: Introductionmentioning

confidence: 99%

Mode of Inhalation for Trained and Untrained Asthmatics Using a Pressurized Aerosol

Morén¹,

Andersson²,

Stiksa³

1984

Respiration

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A pressurized inhalation aerosol should be actuated at the beginning of a slow and deep inhalation, followed by a long pause of breathholding. In this study a registration was performed on the mode of inhalation. The flow-volume curve and the moment of actuation were obtained from an aerosol actuator provided with sensors, and the breathholding pause was measured. Data were obtained from 34 asthmatic patients, regularly trained to use the pressurized aerosol, and these data were compared with those from 44 untrained patients. When the subjects used a terbutaline sulfate aerosol in their usual fashion, most of the trained subjects succeeded well. Further improvements could possibly be made regarding the depth of inhalation and, after control with the recording device, regarding the flow rate at actuation. Most of the untrained subjects did not use a deep enough inhalation with respect to their vital capacity, and their breath-holding pause was very short. It only seems possible to improve these parameters by regular training. In order to reach optimal results the asthmatic patients must be regularly controlled and instructed regarding their use of a pressurized inhalation aerosol. A recording device is useful in demonstrating to each subject which parameter can be improved.

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“…As evidenced by many studies in the literature, optimum use of current aerosol devices is deceptively difficult. 27,[34][35][36][37][38][39][40] Unfortunately, the needs and capabilities of patients are not always adequately considered during device development, resulting in a variety of aerosol devices that fail to meet the needs of many patients with pulmonary diseases. It is important to use an aerosol device that generates drug particles in the respirable range (1-5 m) to maximize aerosol delivery to the lungs.…”

Section: Factors Affecting Patient Adherence To Prescribed Aerosol Thmentioning

confidence: 99%

Patient Education and Adherence to Aerosol Therapy

Ari

2015

Respir Care

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SummaryNonadherence to prescribed medications results in disease instability and poor clinical control, with increases in hospital admissions, emergency room visits, school/work absenteeism, morbidity, and mortality. Poor patient adherence to therapy can be due to lack of cognition, competence, or contrivance. Patients who have not been trained or fail to understand use of drug and device combinations (cognition) often do not have the ability to use an aerosol device correctly (competence). Many patients have the competence to use the device correctly and know why they should RESPIRATORY CARE • JUNE 2015 VOL 60 NO 6 941 use the device in the way they were taught; however, they still contrive to use it in an ineffective and suboptimal manner that reduces its efficiency and effectiveness. Ensuring effective aerosol therapy and optimizing its role in disease management involve not only delivery of aerosolized medications to the lungs, but also understanding why, when, and how to use the medications, competence to use the device, motivation to adhere to therapy, and not contriving to use the device in a way that will prevent effective drug delivery. This paper explains some of the problems with patient education and adherence to aerosol therapy and suggests strategies to evaluate, monitor, and improve patient adherence effectively in primary care. Factors affecting patient adherence to prescribed medications, effective educational interventions, and strategies to promote patient adherence to aerosol therapy are also discussed.

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Mauvaise utilisation des aérosol-doseurs par les asthmatiques

Cited by 28 publications

References 6 publications

Asthma and COPD Patients’ Perception of Appropriate Metered-Dose Inhaler Technique

Asthma and COPD Patients’ Perception of Appropriate Metered-Dose Inhaler Technique

Mode of Inhalation for Trained and Untrained Asthmatics Using a Pressurized Aerosol

Patient Education and Adherence to Aerosol Therapy

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