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The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study

Year 2019, Volume: 46 Issue: 2, 321 - 325, 11.06.2019
https://doi.org/10.5798/dicletip.574929

Abstract

Objective: The percentage of asthma patients that use their inhalers with the correct technique ranges between 10 and 60. Inappropriate use of inhaler leads to disuse of drug, diminished disease control and increased drug use. In this study, we aimed to determine the effect of proper inhaler therapy on the treatment and control of asthma and the effect of proper inhaler use on hospitalization due to asthma. 
Method: One hundred and sixty five asthma patients over 18 years of age that applied to either in- or out-patient clinics of a university hospital, that had a diagnosis of asthma according to the criteria of the Global Initiative for Asthma (GINA) and had been attack-free for at least one month were included. Patients were told to use their inhalers and any misuse were noted. Patients were put through the Asthma Control Test (ACT). Their forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF) values were also noted. Their hospitalization status for asthma in the last year was assessed and recorded. 
Results: One hundred patients used their asthma inhalers correctly, while 65 did not. Those that used their inhalers correctly had significantly higher ACT (p=0,0001), FEV1% (p=0,001) and PEF% (p=0,014). 
Discussion: Patients must be informed and trained for the correct use of their inhaler drugs. Patients seem to be under-informed on this subject and there are serious mistakes of use for all inhaler types. Correct use of inhalers leads to better control of disease, lower rate of asthma-related hospitalization, less drug waste and decreased treatment cost. 

References

  • 1. Global Initiative for Asthma(GINA). Global strategy for asthma management and prevention(Update2018).http://ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention/ . Accessed 15 January 2018.
  • 2. Global Initiative for Asthma (GINA). 2017 GINA Report, Global Strategy for Asthma Management and Prevention. http://ginasthma.org/2017-gina-report-global-strategy-for-asthma-management-and-prevention/. Accessed 13 December 2017.
  • 3. Vasbinder EC, Janssens HM, Rutten-van Mölken MP, et all. e-Monitoring of Asthma therapy to improve compliance in children using a real-time medication monitoring system (RTMM): the e-MATIC study protocol. BMC Med Inform Decis Mak. 2013; 13: 38.
  • 4. Bosnic-Anticevich SZ, Stuart M, Mackson J, et all. Development and evaluation of an innovative model of inter-professional education focused on asthma medication use. BMC Med Educ. 2014; 14: 72.
  • 5. Melani AS, Bonavia M, Cilenti V, et all. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011; 105: 930-8.
  • 6. Pedersen S, Dubus JC, Crompton GK; ADMIT Working Group. The ADMIT series--issues in inhalation therapy. Inhaler selection in children with asthma. Prim Care Respir J. 2010; 19: 209-26.
  • 7. Price D, Bosnic-Anticevich S, Briggs A, et all. Inhaler competence in asthma: common errors, barriers to use and recommended solutions.Respir Med. 2013; 107: 37- 46.
  • 8. Al-Jahdali H, Ahmed A, Al-Harbi A, et all. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013; 9: 8.
  • 9. Crompton GK, Barnes PJ, Broeders M, et all. Aerosol Drug Management Improvement Team. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med. 2006; 100: 1479-94.
  • 10. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. http://goldcopd.org/wp- content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed 13 December 2017.
  • 11. Laube BL, Janssens HM, de Jongh, et all. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011; 37: 1308–31.
  • 12. Cochrane MG, Bala MV, Downs KE, et all. Inhaled corticosteroids for asthma therapy. Patient compliance, devices, and inhalation technique. Chest. 2000; 117: 542- 50.
  • 13. Adherence to long-term therapies. Evidence for action. Geneva: World Health Organization (2003). https://www.who.int/chp/knowledge/publications/ad herence_report/en/. Accessed 13 December 2017.
  • 14. Román-Rodríguez M, Metting E, Gacía-Pardo M, et all. Wrong inhalation technique is associated to poor asthma clinical outcomes. Is there room for improvement?.Curr Opin Pulm Med. 2019; 25: 18-26.
  • 15. Erk M. İnhalasyon teknikleri. Toraks Dergisi. 2002; 3:7- 13.
  • 16. Rau JL. Practical problems with aerosol therapy in COPD. Respir Care, 2006; 51: 158-72.
  • 17. Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005; 50: 1360-74.
  • 18. King D, Earnshaw SM, Delaney JC. Pressurised aerosol inhalers: the cost of misuse. Br J Clin Pract. 1991; 45: 48- 9.
  • 19. Lavorini F, Magnan A, Dubus JC, et all. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008; 102: 593-604.
  • 20. Chapman KR, Voshaar TH, Virchow JC. Inhaler choice in primary practice. Eur Respir Rev. 2005; 96: 117-22.
  • 21. Plaza, V, Sanchis, J. Medical personnel and patient skill in the use of metered dose inhalers: a multicentric study. CESEA Group, Respiration. 1998; 65: 195-8.
  • 22. Shrestha, M, Parupia H, Andrews B,et al. Metered-dose inhaler technique of patients in an urban ED: prevalence of incorrect technique and attempt at education. Am J Emerg Med.1996; 14: 380-4.
  • 23. Brocklebank D, Ram F, Wright J, et all. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature, Health Technol Assess. 2001; 5: 1-149.
  • 24. Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J. 2002; 19: 246-51.
  • 25. Van der Palen J, Klein JJ, Kerkhoff AH, et all. Evaluation of the effectiveness of four different inhalers in patients with chronic obstructive pulmonary disease. Thorax.1995; 50: 1183-87.
  • 26. Everard ML, Role of inhaler competence and contrivance in "difficult asthma", Paediatr Respir Rev.2003; 4: 135-42.
  • 27. Aydemir Y. Assessment of the factors affecting the failure to use inhaler devices before and after training. Respir Med. 2015; 109: 451-8.
  • 28. Schuermans D, Hanon S, Wauters I, et all. Impact of a single 10 min education session on asthma control as measured by ACT.Respir Med.2018; 143: 14-17.
  • 29. Rootmensen GN, van Keimpema AR, Jansen HM, et all. Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method. J Aerosol Med Pulm Drug Deliv 2010; 23: 323-8.
  • 30. Goodman DE, Israel E, Rosenberg M, et all. The influence of age, diagnosis, and gender on proper use of metered-dose inhalers. Am J Respir Crit Care Med 1994; 150: 1256-61.
Year 2019, Volume: 46 Issue: 2, 321 - 325, 11.06.2019
https://doi.org/10.5798/dicletip.574929

Abstract

References

  • 1. Global Initiative for Asthma(GINA). Global strategy for asthma management and prevention(Update2018).http://ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention/ . Accessed 15 January 2018.
  • 2. Global Initiative for Asthma (GINA). 2017 GINA Report, Global Strategy for Asthma Management and Prevention. http://ginasthma.org/2017-gina-report-global-strategy-for-asthma-management-and-prevention/. Accessed 13 December 2017.
  • 3. Vasbinder EC, Janssens HM, Rutten-van Mölken MP, et all. e-Monitoring of Asthma therapy to improve compliance in children using a real-time medication monitoring system (RTMM): the e-MATIC study protocol. BMC Med Inform Decis Mak. 2013; 13: 38.
  • 4. Bosnic-Anticevich SZ, Stuart M, Mackson J, et all. Development and evaluation of an innovative model of inter-professional education focused on asthma medication use. BMC Med Educ. 2014; 14: 72.
  • 5. Melani AS, Bonavia M, Cilenti V, et all. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011; 105: 930-8.
  • 6. Pedersen S, Dubus JC, Crompton GK; ADMIT Working Group. The ADMIT series--issues in inhalation therapy. Inhaler selection in children with asthma. Prim Care Respir J. 2010; 19: 209-26.
  • 7. Price D, Bosnic-Anticevich S, Briggs A, et all. Inhaler competence in asthma: common errors, barriers to use and recommended solutions.Respir Med. 2013; 107: 37- 46.
  • 8. Al-Jahdali H, Ahmed A, Al-Harbi A, et all. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013; 9: 8.
  • 9. Crompton GK, Barnes PJ, Broeders M, et all. Aerosol Drug Management Improvement Team. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med. 2006; 100: 1479-94.
  • 10. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. http://goldcopd.org/wp- content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed 13 December 2017.
  • 11. Laube BL, Janssens HM, de Jongh, et all. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011; 37: 1308–31.
  • 12. Cochrane MG, Bala MV, Downs KE, et all. Inhaled corticosteroids for asthma therapy. Patient compliance, devices, and inhalation technique. Chest. 2000; 117: 542- 50.
  • 13. Adherence to long-term therapies. Evidence for action. Geneva: World Health Organization (2003). https://www.who.int/chp/knowledge/publications/ad herence_report/en/. Accessed 13 December 2017.
  • 14. Román-Rodríguez M, Metting E, Gacía-Pardo M, et all. Wrong inhalation technique is associated to poor asthma clinical outcomes. Is there room for improvement?.Curr Opin Pulm Med. 2019; 25: 18-26.
  • 15. Erk M. İnhalasyon teknikleri. Toraks Dergisi. 2002; 3:7- 13.
  • 16. Rau JL. Practical problems with aerosol therapy in COPD. Respir Care, 2006; 51: 158-72.
  • 17. Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005; 50: 1360-74.
  • 18. King D, Earnshaw SM, Delaney JC. Pressurised aerosol inhalers: the cost of misuse. Br J Clin Pract. 1991; 45: 48- 9.
  • 19. Lavorini F, Magnan A, Dubus JC, et all. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008; 102: 593-604.
  • 20. Chapman KR, Voshaar TH, Virchow JC. Inhaler choice in primary practice. Eur Respir Rev. 2005; 96: 117-22.
  • 21. Plaza, V, Sanchis, J. Medical personnel and patient skill in the use of metered dose inhalers: a multicentric study. CESEA Group, Respiration. 1998; 65: 195-8.
  • 22. Shrestha, M, Parupia H, Andrews B,et al. Metered-dose inhaler technique of patients in an urban ED: prevalence of incorrect technique and attempt at education. Am J Emerg Med.1996; 14: 380-4.
  • 23. Brocklebank D, Ram F, Wright J, et all. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature, Health Technol Assess. 2001; 5: 1-149.
  • 24. Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J. 2002; 19: 246-51.
  • 25. Van der Palen J, Klein JJ, Kerkhoff AH, et all. Evaluation of the effectiveness of four different inhalers in patients with chronic obstructive pulmonary disease. Thorax.1995; 50: 1183-87.
  • 26. Everard ML, Role of inhaler competence and contrivance in "difficult asthma", Paediatr Respir Rev.2003; 4: 135-42.
  • 27. Aydemir Y. Assessment of the factors affecting the failure to use inhaler devices before and after training. Respir Med. 2015; 109: 451-8.
  • 28. Schuermans D, Hanon S, Wauters I, et all. Impact of a single 10 min education session on asthma control as measured by ACT.Respir Med.2018; 143: 14-17.
  • 29. Rootmensen GN, van Keimpema AR, Jansen HM, et all. Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method. J Aerosol Med Pulm Drug Deliv 2010; 23: 323-8.
  • 30. Goodman DE, Israel E, Rosenberg M, et all. The influence of age, diagnosis, and gender on proper use of metered-dose inhalers. Am J Respir Crit Care Med 1994; 150: 1256-61.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Bariş Çil 0000-0003-1090-0697

Mehmet Kabak This is me 0000-0003-4781-1751

Ayşe Füsun Topçu This is me 0000-0001-7570-2339

Mahşuk Taylan This is me 0000-0003-4072-2270

Cengizhan Sezgi This is me 0000-0002-5980-3874

Publication Date June 11, 2019
Submission Date December 25, 2018
Published in Issue Year 2019 Volume: 46 Issue: 2

Cite

APA Çil, B., Kabak, M., Topçu, A. F., Taylan, M., et al. (2019). The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study. Dicle Tıp Dergisi, 46(2), 321-325. https://doi.org/10.5798/dicletip.574929
AMA Çil B, Kabak M, Topçu AF, Taylan M, Sezgi C. The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study. diclemedj. June 2019;46(2):321-325. doi:10.5798/dicletip.574929
Chicago Çil, Bariş, Mehmet Kabak, Ayşe Füsun Topçu, Mahşuk Taylan, and Cengizhan Sezgi. “The Proper Use of Inhalers in a Third Step Hospital and Its Effect on Treatment: Original Study”. Dicle Tıp Dergisi 46, no. 2 (June 2019): 321-25. https://doi.org/10.5798/dicletip.574929.
EndNote Çil B, Kabak M, Topçu AF, Taylan M, Sezgi C (June 1, 2019) The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study. Dicle Tıp Dergisi 46 2 321–325.
IEEE B. Çil, M. Kabak, A. F. Topçu, M. Taylan, and C. Sezgi, “The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study”, diclemedj, vol. 46, no. 2, pp. 321–325, 2019, doi: 10.5798/dicletip.574929.
ISNAD Çil, Bariş et al. “The Proper Use of Inhalers in a Third Step Hospital and Its Effect on Treatment: Original Study”. Dicle Tıp Dergisi 46/2 (June 2019), 321-325. https://doi.org/10.5798/dicletip.574929.
JAMA Çil B, Kabak M, Topçu AF, Taylan M, Sezgi C. The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study. diclemedj. 2019;46:321–325.
MLA Çil, Bariş et al. “The Proper Use of Inhalers in a Third Step Hospital and Its Effect on Treatment: Original Study”. Dicle Tıp Dergisi, vol. 46, no. 2, 2019, pp. 321-5, doi:10.5798/dicletip.574929.
Vancouver Çil B, Kabak M, Topçu AF, Taylan M, Sezgi C. The Proper use of Inhalers in a Third Step Hospital and its Effect on Treatment: Original Study. diclemedj. 2019;46(2):321-5.