Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique

Melani, Andrea S.; Bonavia, Marco; E, Mastropasqua; Zanforlin, Alessandro; Lodi, Marco; Martucci, Paola; Scichilone, Nicola; Aliani, Maria; Neri, Margherita; Sestini, Piersante

doi:10.4187/respcare.05117

Cited by 18 publications

(15 citation statements)

References 19 publications

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“…Inhaler misuse is reportedly related to the device type (pMDI), female sex, lower education level, and lower socioeconomic status (17,18). It is generally accepted that pMDI is more error prone than DPI, but studies are inconsistent in the findings of comparisons of DPIs, making it difficult to determine that a particular device shows fewer errors (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Comparing Inhaler Use Technique Based on Inhaler Type in Elderly Patients with Respiratory Disease

Lee¹,

Song

Won

et al. 2021

Tuberc Respir Dis

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Background We aimed to investigate inhaler device handling in elderly patients. Furthermore, we compared inhaler devices with respect to misuse and error correction. Methods Inhaler use technique was assessed using standardized checklists at the first and 3-months follow-up visits after retraining. The primary outcome was differences in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, most common step of misuse, and factors affecting the accuracy of inhaler use. Results A total of 251 patients (mean age, 76.4) were included and the handling of 320 devices was assessed in the study. All patients had been trained before, but only 24.7% of them used inhalers correctly.

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Section: Discussionmentioning

confidence: 99%

Comparing Inhaler Use Technique Based on Inhaler Type in Elderly Patients with Respiratory Disease

Lee¹,

Song

Won

et al. 2021

Tuberc Respir Dis

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show abstract

“…With this format of educational interventions, we can expect almost all patients to master inhaler technique. Research indicates that this is the case for all devices, even though the time to teach the correct use of different devices ranges from 2 and 8 min depending on the device [47,51]; pMDIs requiring longer than dry powder inhalers [51]. As part of this process, tools such as the In-CheckDial, Inhalation Manager, Aerosol Inhalation Monitor (AIM), the 2Tone Metered Dose Inhaler Training Device, the SmartMist and multimedia training tools which utilizes video clips have been successfully used to train patients in the use of their inhalers [52,53].…”

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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“…41 When compared with younger patients, older patients make more attempts before mastering the inhalation technique for a specifi c device, and need longer instruction time from trained health care professionals to correct inhaler mishandling. 49,50 In elderly patients with adequate cognitive and manual ability, the most important factors in selecting a device are availability, convenience, ease of use, patient preference, and cost. 8,23 Device continuity is a key consideration when multiple inhaled medications are needed.…”

Section: S25mentioning

confidence: 99%

“…3 Face-to-face instruction from trained caregivers for approximately 5 to 10 minutes improves the use of MDIs and DPIs by patients. 49 However, clinical research indicates that learning correct handling and use may be easier and quicker for some devices than for others. 31,49 For example, patients naïve to the PulmoJet (a DPI device not currently available in the United States) were found to have fewer serious errors after training than those using Diskus or Turbuhaler devices.…”

Section: Inhaler Device Training For Patients and Physiciansmentioning

confidence: 99%

“…49 However, clinical research indicates that learning correct handling and use may be easier and quicker for some devices than for others. 31,49 For example, patients naïve to the PulmoJet (a DPI device not currently available in the United States) were found to have fewer serious errors after training than those using Diskus or Turbuhaler devices. 24 In another study, it took less time to correct errors in inhaler use with the Diskus compared with the Handi-Haler.…”

Section: Inhaler Device Training For Patients and Physiciansmentioning

confidence: 99%

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Considerations for Optimal Inhaler Device Selection in Chronic Obstructive Pulmonary Disease

Dhand

Cavanaugh

Skolnik³

2018

CCJM

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Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique

Cited by 18 publications

References 19 publications

Comparing Inhaler Use Technique Based on Inhaler Type in Elderly Patients with Respiratory Disease

Comparing Inhaler Use Technique Based on Inhaler Type in Elderly Patients with Respiratory Disease

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

Considerations for Optimal Inhaler Device Selection in Chronic Obstructive Pulmonary Disease

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