Abstract:Several modifiable factors leading to poor asthma control have been described. We aimed to determine the proportion of patients with inadequate treatment, adherence to it, or critical mistakes with inhaler technique, and their impact on asthma control. We conducted a cross-sectional multicenter observational study including asthma patients referred from primary to specialist care for the first time. Data collected were adequate prescription according to guidelines, treatment adherence, and disease control. Of … Show more
“…7,8 Another study revealed that in-adequate prescription, non-adherence to treatment and inhaler misuse were responsible factors for bad asthma control. 10 House-dust was proven to be associated with asthma in our study as also various guidelines on immunotherapy in Asthma. 11 As per the study on children done by Okasha et al, 12 sensitisation to house dust mite increased asthma severity and decreased the ability to control symptoms.…”
Background: Despite the availability of effective therapy, disease control in Asthma remains suboptimal with high morbidity.
Objectives: To assess treatment adherence, asthma control and its influencing factors.
Methodology: A prospective, observational study was conducted among 152 adult asthma patients reporting consecutively to a BPHC for twelve months. Patients were followed up by trained healthcare workers to assess their treatment adherence and disease control using a predesigned, pretested and validated questionnaire.
Results: Mean age was 49.6 years (SD = +14.0), males reported more cases (73.7%), addiction to tobacco was high (48.7%). 40.8% patients had high treatment adherence. Only 37.5% patients reported good asthma control of which 68.4% showed high adherence. The mean Asthma Control Test (ACT) score was 18.75 ± 4.8 SD. Increasing age (aOR=0.96, 95% CI= 0.93-0.99), tobacco smoking (aOR=2.90, 95% CI=1.20-6.99), dust allergy (aOR= 7.92, CI =3.15-19.91) and low treatment adherence (aOR=5.33, 95% CI=2.22-12.82) were found to be significant predictors of poor disease control.
Conclusions: Non adherence to treatment and poor disease control were high among rural asthma patients. Patient education for tobacco cessation and treatment compliance along with periodic monitoring undertaken by trained health workers can be an effective strategy to reduce disease burden in the community.
“…7,8 Another study revealed that in-adequate prescription, non-adherence to treatment and inhaler misuse were responsible factors for bad asthma control. 10 House-dust was proven to be associated with asthma in our study as also various guidelines on immunotherapy in Asthma. 11 As per the study on children done by Okasha et al, 12 sensitisation to house dust mite increased asthma severity and decreased the ability to control symptoms.…”
Background: Despite the availability of effective therapy, disease control in Asthma remains suboptimal with high morbidity.
Objectives: To assess treatment adherence, asthma control and its influencing factors.
Methodology: A prospective, observational study was conducted among 152 adult asthma patients reporting consecutively to a BPHC for twelve months. Patients were followed up by trained healthcare workers to assess their treatment adherence and disease control using a predesigned, pretested and validated questionnaire.
Results: Mean age was 49.6 years (SD = +14.0), males reported more cases (73.7%), addiction to tobacco was high (48.7%). 40.8% patients had high treatment adherence. Only 37.5% patients reported good asthma control of which 68.4% showed high adherence. The mean Asthma Control Test (ACT) score was 18.75 ± 4.8 SD. Increasing age (aOR=0.96, 95% CI= 0.93-0.99), tobacco smoking (aOR=2.90, 95% CI=1.20-6.99), dust allergy (aOR= 7.92, CI =3.15-19.91) and low treatment adherence (aOR=5.33, 95% CI=2.22-12.82) were found to be significant predictors of poor disease control.
Conclusions: Non adherence to treatment and poor disease control were high among rural asthma patients. Patient education for tobacco cessation and treatment compliance along with periodic monitoring undertaken by trained health workers can be an effective strategy to reduce disease burden in the community.
“…All in all, the available data support the assumption that the Easyhaler presents benefits which include consistency of dose [ 43 ], achievement of optimal PIFR [ 51 ], few critical errors in use [ 49 ], and overall high patient satisfaction [ 33 , 37 ]. Moreover, reduction in emissions of greenhouse gases was shown compared to MDIs.…”
Section: Discussionmentioning
confidence: 99%
“…Critical errors of inhaler use related strongly to poor asthma control (OR 3.03, 95% CI 2.18–4.21) (Fig. 5 ) [ 49 ]. Fig.…”
Section: Discussionmentioning
confidence: 99%
“…Significantly fewer critical mistakes were recorded among Easyhaler users versus other dry-powder inhaler users (10.3 vs. 18.4%; p < 0.05). Redrawn after Ribó et al [ 49 ] …”
Asthma and chronic obstructive pulmonary disease (COPD) are major causes of morbidity and mortality worldwide. Optimal control of these conditions is a constant challenge for both physicians and patients. Poor inhaler practice is widespread and is a substantial contributing factor to the suboptimal clinical control of both conditions. The practicality, dependability, and acceptability of different inhalers influence the overall effectiveness and success of inhalation therapy. In this paper, experts from various European countries (Finland, Germany, Hungary, Italy, Poland, Spain, and Sweden) address inhaler selection with special focus on the Easyhaler
®
device, a high- or medium–high resistance dry-powder inhaler (DPI). The evidence examined indicates that use of the Easyhaler is associated with effective control of asthma or COPD, as shown by the generally accepted indicators of treatment success. Moreover, the Easyhaler is widely accepted by patients, is reported to be easy to learn and teach, and is associated with patient adherence. These advantages help patient education regarding correct inhaler use and the rational selection of drugs and devices. We conclude that switching inhaler device to the Easyhaler may improve asthma and COPD control without causing any additional risks. In an era of climate change, switching from pressurized metered-dose inhalers to DPIs is also a cost-effective way to reduce emissions of greenhouse gases.
Supplementary Information
The online version contains supplementary material available at 10.1007/s41030-021-00174-5.
“…Investigators also found that an absence of inhaler technique review in the past 12 months was strongly associated with severe error in inhaler technique 13 . Studies have reported modifiable risk factors that affect respiratory disease state control, poor inhaler adherence, inappropriate prescriptions, and inhaler misuse 14,15 . Commonly reported errors in inhaler use include failure to exhale before inhaling, 13,16 failure to hold breath, 13,16 insufficient force of inhalation, 13 failure to pierce button completely, 16 not holding the inhaler upright, 16 and failure to gargle after inhalation 16 .…”
Introduction: Appropriate inhaler technique is important for optimizing treatment of pulmonary conditions, including asthma and chronic obstructive pulmonary disease.Nurses often administer inhaled medications in the acute care setting, providing an opportunity to educate patients on appropriate inhaler technique. To date, no published study has evaluated the impact of pharmacist-led training on skill improvement and retention among acute care pulmonary nursing staff regarding their ability to instruct a patient on inhaler technique.Objective: The primary objective of this study was to evaluate both the immediate and sustained impact of pharmacist-led inhaler technique for acute care pulmonary nurses using hands-on training for instructing on appropriate inhaler use. Methods: This prospective study used a one group pre-test, posttest design for an educational intervention. Pharmacists conducted a brief in-service followed by an individualized simulation where the nurse participant instructed a standardized patient on how to use a placebo metered dose inhaler (MDI) and dry powder inhaler (DPI) before and after receiving individual technique training by a pharmacist. Participant inhaler counseling technique was assessed via standardized checklist. Nurses then received individual coaching from a pharmacist regarding proper inhaler technique. After the pharmacist intervention, the nurse again counseled the standardized patient on how to use the devices. Measures included investigator rating on inhaler technique at baseline, after training, and 2 months later. Results: After the interventions, participant performance significantly improved for MDI and DPI technique. At the 2-month follow-up, there was a statistically significant increase for MDI and DPI technique from baseline. Conclusion: Brief, pharmacist-led inhaler technique education results in sustained improvements in inhaler administration skills among pulmonary nursing staff.
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