Potential benefit of repeated MDI inhalation technique counselling for patients with asthma

Abstract

ObjectivesThe aim of this study was to examine the effect of metered dose inhaler (MDI) counselling on the inhalation technique and pulmonary function test scores of patients with asthma.Methods491 subjects with asthma (281 female) attending the Beni Suef University hospital outpatient clinics were enrolled during a 2-year period. Their mean (SD) age was 42.1 (17.1) years. Their MDI inhalation technique was checked and the number of mistakes was noted and corrected at the first visit and at each of two following monthly visits (three visits in total). Their peak expiratory flow and forced expiratory volume in 1 s (FEV1) as a percentage of the forced vital capacity were checked at each visit.ResultsMost MDIs contained salbutamol, although some patients were using MDIs containing beclomethasone or a combination of beclomethasone and salbutamol. The mean number of mistakes observed decreased significantly (p<0.001) as the number of visits increased, especially in the children's group. The most common repeated mistake was failure to maintain a slow inhalation rate until the lungs were full. There was a significant improvement (p<0.001) in pulmonary function test scores after counselling in all age groups, particularly in those aged >60 years.ConclusionsMDI counselling should be frequently repeated to improve and maintain the recommended MDI inhalation technique and possibly improve patients’ pulmonary function tests scores.

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

“…These factors might led to inhaler misuse[22].The effects of Aerolizer counselling on PEF, FEV 1 /FVC% were similar to our previously published effects of MDI counselling[4]. This was expected, as the improvement in pulmonary function tests with patient adherence to treatment and correct use of their inhaler, either DPI or MDI, should improve the patients' PFTs regardless the type of the device they use[1,[15][16][17].However, the total number of mistakes when using an MDI was much higher than with a DPI for all groups in all visits.…”

“…There was no significant difference in number of mistakes between the three age groups in the three visits. The number of mistakes of each step in the three visits is presented in Table 2 [4,28].…”

“…However, they are often not properly used, leading to uncontrolled disease and increased costs [1]. This remains a common problem in obstructive lung diseases [2][3][4] Journal explained how training in proper technique might be of practical importance [5]. The worldwide costs associated with the management of asthma and chronic obstructive pulmonary disease (COPD) in adults and children are very large, from both the healthcare payer and the societal points of view [6][7][8][9][10].…”

“…In a more than 10-year-old review of 21 studies looking at misuse of inhalers, poor technique was estimated to be prevalent in 14-90 % (with an average of 50 %) of cases [11]. This level of misuse is still presented in recent studies [4,[12][13][14][15][16][17]. However, the same studies showed that a substantial increase in correct use occurred after training [4,[12][13][14][15][16][17].…”

“…This level of misuse is still presented in recent studies [4,[12][13][14][15][16][17]. However, the same studies showed that a substantial increase in correct use occurred after training [4,[12][13][14][15][16][17]. Further improvement in correct use as well as lung function occurred with repeated counseling [4].…”