Potential Benefit of Repeated Dry Powder Inhaler’s Inhalation Technique Counseling on Asthmatic Patients

Elgendy, Marwa O.; Abdelrahim, Mohamed; Eldin, Randa Salah

doi:10.1007/s41030-015-0004-9

Cited by 45 publications

(47 citation statements)

References 34 publications

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“…Similar to earlier studies, 5,42,43 the results showed that a high number of subjects using MDI did not achieve MDI inhalation technique correct in the visit 1 but they significantly got better in the visit 2 ( P < .001) and improved more in the visit 3 ( P < .001) 14,24,26‐28,32 . Therefore, continuous counselling of the asthmatic subjects significantly correlates with the proper MDI inhalation technique ( P < .001) 24,29,44‐46 . Additional care should be given to this counselling after observing the results of the first group which did not improve at all with 95 subjects dropping out of the study 34 .…”

Section: Discussionsupporting

confidence: 77%

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The potential benefit of continuous metered‐dose inhaler inhalation technique verbal counselling on asthmatic

et al. 2020

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Background Subjects’ improper usage of their metered‐dose inhalers (MDI) is considered a chief cause of poor asthma control. The work presented here aims to evaluate the effect of MDI verbal counselling on subjects’ lung function and inhalation technique. Method A total number of 900 asthmatic subjects (450 female) were gathered from University hospital outpatient clinics from January 2017 to May 2019 with a mean (SD) age 45.2 (17.1) years old. They were divided into two groups. The first was monthly asthma follow‐up, for three visits, (450 (266 females) subjects). The other group was monthly asthma follow‐up, for three visits plus MDI inhalation technique verbal counselling (450 (184 female) subjects). At the beginning of studying group 2 and at every monthly visit (three visits), each subject was asked to show the investigator his MDI inhalation technique and the number of mistakes was noticed and adjusted. Additionally, at each visit, their forced expiratory volume in one second (FEV1) as a percentage of the forced vital capacity (FVC) and peak expiratory flow (PEF) were measured. Results No subject dropped out from group 2; however, 95 subjects dropped out from group 1 with no improvement in the lung function tests. The mean number of accurate steps of the MDI inhalation technique observed in group 2 was improved significantly (P < .001) as the number of visits increased particularly in children. “Start to inhale slowly, through the mouth and at the same time press the canister to actuate a dose and maintain a slow and deep inhalation, through the mouth, until the lungs are full of air (This should take an adult 4‐5 seconds)” was the common repetitive mistake. There was a significant improvement (P < .05) in the lung function test scores after the counselling in group 2, especially in old subjects. Conclusions MDI’s counselling must be continually offered to the asthmatic subject at any possible chance to improve and sustain the optimal MDI inhalation technique and probably improve subjects’ lung function score.

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Section: Discussionsupporting

confidence: 77%

“…Continuous counselling of asthmatics improves their long‐term asthma control and has vital role in the proper managing of various limitations of airflow 16‐18 . It also may increase the pulmonary function tests score, quality of life and asthmatic subjects’ illness 19‐32 …”

Section: Introductionmentioning

confidence: 99%

The potential benefit of continuous metered‐dose inhaler inhalation technique verbal counselling on asthmatic

et al. 2020

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“…Although systemic delivered therapy is available for asthma and chronic obstructive pulmonary disease (COPD), inhaled therapy is the most widely used option [1][2][3]. The reason behind that is the better safety index for the inhaled way [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparison between traditional and nontraditional add-on devices used with pressurised metered-dose inhalers

et al. 2020

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Add-on devices that are attached to metered-dose inhalers (MDIs) were introduced to improve aerosol delivery. The objective of this study was to determine the efficacy of drug delivery from an MDI when attached to different add-on devices at different inhalation volumes.The total emitted dose (TED) of salbutamol was estimated for the MDI alone and the MDI connected to five different add-on devices (Able valved holding chamber, Tips-haler valved holding chamber, Aerochamber plus flow Vu valved holding chamber, Dolphin chamber, and a handmade water bottle spacer), at inhalation flow of 28.3 L·min−1 with flow volume of 1, 2 and 4 L, assuming young child (aged <6 years), old child (>6 years) and adult inhalation volumes, respectively.The TED% ranged between 84.1% and 87.2% at all inhalation volumes from the MDI alone, which was significantly greater than all MDI add-on device combinations (p<0.05). The TED% delivered to MDI sampling apparatus by a homemade water bottle spacer and Dolphin chamber, as non-antistatic add-on devices, ranged between 30.5% and 35.3%. However, washing these non-antistatic add-on devices with a light detergent before use improved their TED to range between 47.6% and 51.2%. Non-antistatic add-on devices had significantly lower TED (p<0.05) than that delivered by most antistatic add-on devices, which ranged from 51.3% to 71.6%.This study suggests that antistatic add-on devices delivered much more aerosol than non-antistatic add-on devices. However, it may be advised to still use a non-antistatic add-on device, for the sake of solving the coordination problem, and wash it with light detergent before use to improve TED.

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“…Inhaler technique needs to be checked and education repeated over time. It is now well established that having the physical skill to use an inhaler does not guarantee that a patient will continue to use an inhaler correctly over time, with approximately 50% of patients failing to maintain correct inhaler technique over time [54][55][56][57][58]. While there are tools that can be used in addition to physical demonstration to improve this [59], the starting point is a follow-up of inhaler technique over time by the health care practitioner.…”

Section: What Do Health Care Practitioners Need To Consider In Addresmentioning

confidence: 99%

Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management

et al. 2018

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Medication use has always played a highly significant role in the overall management of asthma, with appropriate use being linked to good asthma control. However, while patients with asthma enjoy the 'luxury' of having medications delivered directly to the lungs via inhaler devices, with that comes the additional challenge of ensuring that inhaler devices are used correctly. Research and practice provides evidence to the challenges associated with inhaler use and the particular steps that patients perform incorrectly. While this problem is well documented, acknowledged and reported, little has changed in 40 years, and the proportion of patients using inhaler devices remains unacceptably high. This review focuses on aspects specific to the errors that patient's make, the significance of these errors, and the important considerations for health care practitioners in supporting patients in correctly using their inhalers. This review highlights the complexities associated with patient's making inhaler technique errors and highlights the opportunities that lie in future technological developments of inhaler devices. Now more than ever, in the era of precision medicine, it is important that we address inhaler technique use once and for all.Keywords: Asthma control; Critical errors; Health behavior; Health care practitioners; Inhaler devices; Maintenance; Mastery; Skills THE IMPORTANCE OF MEDICATION USE IN OUR UNDERSTANDING OF RESPIRATORY DISEASEAfter decades of research, practice, and perceived knowledge, we find ourselves at crossroads in our understanding and management of airway diseases, such as asthma [1]. While asthma is an obstructive airways disease, which Pulm Ther (2018) 4:1-12 https://doi.org/10.1007/s41030-018-0051-0 to our current knowledge can neither be prevented nor cured, it is a disease that fluctuates in severity and 'control', is exacerbated by varying triggers, and its course over an individual's lifetime is essentially unpredictable [1]. While the conversation about asthma and airways disease more broadly is not the focus of this review, it becomes particularly relevant in our consideration of the use of medications. It is critical, now more than ever, that we understand the role of medication use, as it can provide us with further understanding about respiratory disease more broadly [2]. Given that asthma management is reliant on the use of medications [3], ensuring that patients use their medications correctly has become more than just a practical matter; it is a complex and critical issue. Correct medication use has become a fundamental step in our exploration and understanding of disease traits [1,2]: with careful and more precise evaluation of patient's response to treatment becoming integral to our understanding of disease endotypes and our evolution towards precision medicine [1,2]. For this reason, if for no other, it is now more important than ever that we address inhaler use, especially our knowledge of critical errors, which can 'cloud' our understanding of treatment success. T...

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Potential Benefit of Repeated Dry Powder Inhaler’s Inhalation Technique Counseling on Asthmatic Patients

Cited by 45 publications

References 34 publications

The potential benefit of continuous metered‐dose inhaler inhalation technique verbal counselling on asthmatic

The potential benefit of continuous metered‐dose inhaler inhalation technique verbal counselling on asthmatic

Comparison between traditional and nontraditional add-on devices used with pressurised metered-dose inhalers

Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management

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