Potential Benefit of Repeated Dry Powder Inhaler’s Inhalation Technique Counseling on Asthmatic Patients
Tóm tắt
The aim of the work presented here was to determine the role of dry powder inhaler (DPI) counselling on inhalation technique and lung function test scores of the asthmatic patients. To decrease variability, asthmatic patients using an Aerolizer were enrolled in the study, as this was the most commonly prescribed DPI in outpatient clinics of Beni Suef University hospital. Each patient was subjected to three visits separated by 1 month each. In each visit, patient inhalation technique from the DPI was checked, and the number of mistakes was identified and corrected. Also, patients’ peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) presented as a percentage of the forced vital capacity (FVC) were checked. As the number of visits increased, the mean number of observed mistakes was significantly decreased (p < 0.001). The most common repeated mistakes were “To inhale fast” and “To maintain a fast inhalation rate until the lungs are full”. In all age groups, there was a significant increase (p < 0.001) in the pulmonary function test after the period of counselling. To improve and maintain the recommended inhalation technique of DPI and possibly improve patients’ lung function test scores, counselling on proper DPI technique should be repeated at every possible opportunity.
Tài liệu tham khảo
Bousquet J, Mantzouranis E, Cruz AA, Aït-Khaled N, Baena-Cagnani CE, Bleecker ER, et al. Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010;126(5):926–38.
Press VG, Arora VM, Shah LM, Lewis SL, Ivy K, Charbeneau J, et al. Misuse of respiratory inhalers in hospitalized patients with asthma or COPD. J Gen Intern Med. 2011;26(6):635–42.
Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930–8.
Elgendy MO, Abdelrahim ME, Salah Eldin R. Potential benefit of repeated MDI inhalation technique counselling for patients with asthma. Eur J Hospital Pharm. 2015; doi:10.1136/ejhpharm-2015-000648 (In press).
Papi A, Haughney J, Virchow J, Roche N, Palkonen S, Price D. Inhaler devices for asthma: a call for action in a neglected field. Eur Respir J. 2011;37(5):982–5.
Schramm B, Ehlken B, Smala A, Quednau K, Berger K, Nowak D. Cost of illness of atopic asthma and seasonal allergic rhinitis in Germany: 1 year retrospective study. Eur Respir J. 2003;21(1):116–22.
Herjavecz I, Boszormenyi Nagy G, Gyurkovits K, Magyar P, Dobos K, Nagy L, et al. Cost, morbidity, and control of asthma in Hungary: the Hunair study. J Asthma. 2003;40(6):673–81.
Sullivan S. The burden of uncontrolled asthma on the US health care system. Manag Care. 2005;14(8):4–7 (discussion 25–7).
Godard P, Chanez P, Siraudin L, Nicoloyannis N, Duru G. Costs of asthma are correlated with severity: a 1-year prospective study. Eur Respir J. 2001;19(1):61–7.
Leigh JP, Yasmeen S, Miller TR. Medical costs of fourteen occupational illnesses in the United States in 1999. Scand J Work Environ Health. 2003:304–13.
Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J. 2002;19(2):246–51.
Roche N, Chrystyn H, Lavorini F, Agusti A, Virchow JC, Dekhuijzen R, et al. Effectiveness of inhaler devices in adult asthma and COPD. Eur Med J. 2013;1:64–71.
Hämmerlein A, Müller U, Schulz M. Pharmacist-led intervention study to improve inhalation technique in asthma and COPD patients. J Eval Clin Pract. 2011;17(1):61–70.
Dantic DE. A critical review of the effectiveness of ‘teach-back’technique in teaching COPD patients self-management using respiratory inhalers. Health Edu J. 2014;73(1):41–50.
Andreevska K, Petkova V, Jordanova S, Grekova D, Madjarov V, Dimitrova M, et al. Effect of education on patients with chronic obstructive pulmonary disease. World J Pharm Pharm Sci. 2013;3(3):01–9.
Shareef J, Sajitha M, Shastry C. Impact of pharmacist provided patient counseling on quality of life inpatients with asthma in a tertiary care teaching hospital. Int J Pharma Res Rev. 2014;3(2):1–10.
Saji M, Alhas JJK, Siraj S. Study on the impact of patient counseling on the quality of life and pulmonary function of asthmatic patient. Int J Pharm Pharm Sci. 2012;4(Suppl 5):300–4.
Tan N, Ng C, Goh S, Lee C. Assessment of metered dose inhaler technique in family health service patients in Singapore. Singapore Med J. 1999;40(7):465–7.
Molimard M, Le Gros V. Impact of patient-related factors on asthma control. J Asthma. 2008;45(2):109–13.
Basheti IA, Reddel HK, Armour CL, Bosnic-Anticevich SZ. Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists. J Allergy Clin Immunol. 2007;119(6):1537–8.
Lareau SC, Yawn BP. Improving adherence with inhaler therapy in COPD. Int J Chronic Obstruct Pulmonary Dis. 2010;5:401–6.
To KW, Lee WM, Choi KC, Yu D, Chau J, Lee I. Educational and supportive interventions for improving adherence to inhalation therapy in people with chronic respiratory diseases: a systematic review protocol. JBI Database Syst Rev Implement Rep. 2013;11(1):329–45.
Bryant J, McDonald VM, Boyes A, Sanson-Fisher R, Paul C, Melville J. Improving medication adherence in chronic obstructive pulmonary disease: a systematic. Respir Res. 2013;14:109.
Lavorini F. The Challenge of Delivering Therapeutic Aerosols to Asthma Patients. ISRN Allergy. 2013;2013:1–17. doi:10.1155/2013/102418.
Lavorini F, Magnan A, Christophe Dubus J, Voshaar T, Corbetta L, Broeders M, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102(4):593–604.
Newman S. Inhaler treatment options in COPD. Eur Respir Rev. 2005;14(96):102–8.
Hilton S. An audit of inhaler technique among asthma patients of 34 general practitioners. Br J Gen Pract. 1990;40(341):505–6.
Kamps A, Brand P, Roorda R. Determinants of correct inhalation technique in children attending a hospital-based asthma clinic. Acta Paediatr. 2002;91(2):159–63.
Newman S, Busse W. Evolution of dry powder inhaler design, formulation, and performance. Respir Med. 2002;96(5):293–304.
Abdelrahim ME. Emitted Dose and Lung Deposition of Inhaled Terbutaline from Turbuhaler at Different Conditions. Respir Med. 2010;104(5):682–9.
Abdelrahim M, Assi K, Chrystyn H. Dose emission and aerodynamic characterization of the terbutaline sulphate dose emitted from a Turbuhaler at low inhalation flow. Pharm Dev Technol. 2013;18(4):944–9.
Azouz W, Chetcuti P, Hosker HS, Saralaya D, Stephenson J, Chrystyn H. The inhalation characteristics of patients when they use different dry powder inhalers. J Aerosol Med Pulm Drug Deliv. 2014;28(1):35–42.
Adachi YS, Adachi Y, Itazawa T, Yamamoto J, Murakami G, Miyawaki T. Ability of preschool children to use dry powder inhalers as evaluated by In-Check Meter. Pediatr Int. 2006;48(1):62–5.
Broeders ME, Molema J, Vermue NA, Folgering HTM. In check dial: accuracy for Diskus and Turbuhaler. Int J Pharm. 2003;252(1):275–80.
Chrystyn H. Is inhalation rate important for a dry powder inhaler? Using the in-check dial to identify these rates. Respir Med. 2003;97(2):181–7.
Rau JL. Practical problems with aerosol therapy in COPD. Respir care. 2006;51(2):158–72.
Sims MW. Aerosol therapy for obstructive lung diseases. Chest. 2011;140(3):781–8. doi:10.1378/chest.10-2068.
Tashkin DP, Ferguson GT. Combination bronchodilator therapy in the management of chronic obstructive pulmonary. Respir Res. 2013;14:49.
Shrestha R, Shakya R. Comparison of bronchodilator effect of salbutamol delivered via MDI and DPI in COPD patients. SAARC J Tuberculosis Lung Dis HIV/AIDS. 2009;6(2):22–30.
Chipps BE. Inhaled corticosteroid therapy for patients with persistent asthma: learnings from studies of inhaled budesonide. Allergy Asthma Proc. 2009;30(3):217–28.