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Erschienen in: Advances in Therapy 7/2018

15.06.2018 | Original Research

The Impact of Adding a Training Device to Familiar Counselling on Inhalation Technique and Pulmonary Function of Asthmatics

verfasst von: Mina Nicola, Ahmed Elberry, Ossama Sayed, Raghda Hussein, Haitham Saeed, Mohamed Abdelrahim

Erschienen in: Advances in Therapy | Ausgabe 7/2018

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Abstract

Introduction

We have investigated the effect of adding a pressurized metered dose inhaler (pMDI) training device to verbal counselling on pulmonary function and inhalation technique.

Methods

A total of 304 adult asthmatic subjects (> 18 years old) were enrolled in a 3-month study of assessment and education. They were divided into an investigation group (Trainhaler plus Flo-Tone and verbal counselling, n = 261, mean age 49.2 years) and a control group (verbal counselling only, n = 43, mean age 48.7 years). Pulmonary function and inhalation technique were evaluated, mistakes noted, and the correct technique advised at three consecutive monthly visits. Visits also included verbal pMDI counselling (both groups) and training device coaching (investigation group).

Results

By visit 2, the mean number of technique errors decreased significantly (p < 0.05) in both groups (investigation group p < 0.001). The investigation group demonstrated a marked decrease in the frequency of the critical error of maintaining a slow inhalation rate until the lungs are full—a technique difficult to learn via verbal counselling alone. The improvement in pulmonary function was significant from the second clinic visit in the investigation group (p < 0.05) and from the third visit in both groups (p < 0.001).

Conclusions

Use of a training device combined with verbal counselling improved inhalation technique. An earlier, significant improvement was also noted in pulmonary function.
Literatur
1.
Zurück zum Zitat Laube BL, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir Soc. 2011;37(6):1308–31.CrossRef Laube BL, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir Soc. 2011;37(6):1308–31.CrossRef
2.
Zurück zum Zitat Sanchis J, et al. Inhaler devices—from theory to practice. Respir Med. 2013;107(4):495–502.CrossRefPubMed Sanchis J, et al. Inhaler devices—from theory to practice. Respir Med. 2013;107(4):495–502.CrossRefPubMed
3.
Zurück zum Zitat Dolovich MB, Dhand R. Aerosol drug delivery: developments in device design and clinical use. Lancet. 2011;377(9770):1032–45.CrossRefPubMed Dolovich MB, Dhand R. Aerosol drug delivery: developments in device design and clinical use. Lancet. 2011;377(9770):1032–45.CrossRefPubMed
4.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
5.
Zurück zum Zitat Abdelrahim ME. Emitted dose and lung deposition of inhaled terbutaline from turbuhaler at different conditions. Respir Med. 2010;104(5):682–9.CrossRefPubMed Abdelrahim ME. Emitted dose and lung deposition of inhaled terbutaline from turbuhaler at different conditions. Respir Med. 2010;104(5):682–9.CrossRefPubMed
6.
Zurück zum Zitat Elgendy MO, Abdelrahim ME, Eldin RS. Potential benefit of repeated dry powder inhaler’s inhalation technique counseling on asthmatic patients. Pulm Ther. 2015;1(1):91–101.CrossRef Elgendy MO, Abdelrahim ME, Eldin RS. Potential benefit of repeated dry powder inhaler’s inhalation technique counseling on asthmatic patients. Pulm Ther. 2015;1(1):91–101.CrossRef
7.
Zurück zum Zitat Ali A, Abdelrahim M. Modeling and optimization of terbutaline emitted from a dry powder inhaler and influence on systemic bioavailability using data mining technology. J Pharm Innovation. 2014;9(1):38–47.CrossRef Ali A, Abdelrahim M. Modeling and optimization of terbutaline emitted from a dry powder inhaler and influence on systemic bioavailability using data mining technology. J Pharm Innovation. 2014;9(1):38–47.CrossRef
9.
Zurück zum Zitat Stein SW, et al. Advances in metered dose inhaler technology: hardware development. AAPS Pharm Sci Tech. 2014;15(2):326–38.CrossRef Stein SW, et al. Advances in metered dose inhaler technology: hardware development. AAPS Pharm Sci Tech. 2014;15(2):326–38.CrossRef
10.
Zurück zum Zitat Bosnic-Anticevich SZ. Inhaler device handling: have we really started to address the problem? Eur Respir Soc. 2017;49(2):1700120.CrossRef Bosnic-Anticevich SZ. Inhaler device handling: have we really started to address the problem? Eur Respir Soc. 2017;49(2):1700120.CrossRef
11.
Zurück zum Zitat Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005;50(10):1360–75.PubMed Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005;50(10):1360–75.PubMed
12.
Zurück zum Zitat George CM, Schrock M. Inhalation therapy: help patients avoid these mistakes. J Fam Pract. 2011;60(12):714a–20a. George CM, Schrock M. Inhalation therapy: help patients avoid these mistakes. J Fam Pract. 2011;60(12):714a–20a.
13.
Zurück zum Zitat Papi A, et al. Inhaler devices for asthma: a call for action in a neglected field. Eur Respir Soc. 2011;37(5):982–5.CrossRef Papi A, et al. Inhaler devices for asthma: a call for action in a neglected field. Eur Respir Soc. 2011;37(5):982–5.CrossRef
14.
Zurück zum Zitat Saji M, Alhas J, 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. Saji M, Alhas J, 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.
15.
Zurück zum Zitat 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. 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.
16.
Zurück zum Zitat Small M, et al. Importance of inhaler-device satisfaction in asthma treatment: real-world observations of physician-observed compliance and clinical/patient-reported outcomes. Adv Ther. 2011;28(3):202–12.CrossRefPubMed Small M, et al. Importance of inhaler-device satisfaction in asthma treatment: real-world observations of physician-observed compliance and clinical/patient-reported outcomes. Adv Ther. 2011;28(3):202–12.CrossRefPubMed
17.
Zurück zum Zitat Gamble J, Stevenson M, Heaney LG. A study of a multi-level intervention to improve non-adherence in difficult to control asthma. Respir Med. 2011;105(9):1308–15.CrossRefPubMed Gamble J, Stevenson M, Heaney LG. A study of a multi-level intervention to improve non-adherence in difficult to control asthma. Respir Med. 2011;105(9):1308–15.CrossRefPubMed
18.
Zurück zum Zitat Joshi AV, et al. Association of medication adherence with workplace productivity and health-related quality of life in patients with asthma. J Asthma. 2006;43(7):521–6.CrossRefPubMed Joshi AV, et al. Association of medication adherence with workplace productivity and health-related quality of life in patients with asthma. J Asthma. 2006;43(7):521–6.CrossRefPubMed
19.
Zurück zum Zitat Elgendy MO, Abdelrahim ME, Salah Eldin R. Potential benefit of repeated MDI inhalation technique counselling for patients with asthma. Eur J Hosp Pharm. 2015;22(6):318–22.CrossRef Elgendy MO, Abdelrahim ME, Salah Eldin R. Potential benefit of repeated MDI inhalation technique counselling for patients with asthma. Eur J Hosp Pharm. 2015;22(6):318–22.CrossRef
20.
Zurück zum Zitat Welch MJ, et al. Evaluation of MDI inhaler technique using a new training device. J Allergy Clin Immunol. 2015;135(2):AB48.CrossRef Welch MJ, et al. Evaluation of MDI inhaler technique using a new training device. J Allergy Clin Immunol. 2015;135(2):AB48.CrossRef
21.
Zurück zum Zitat Roche N, et al. Effectiveness of inhaler devices in adult asthma and COPD. EMJ Respir. 2013;1:64–71. Roche N, et al. Effectiveness of inhaler devices in adult asthma and COPD. EMJ Respir. 2013;1:64–71.
22.
Zurück zum Zitat To KW, et al. 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.CrossRef To KW, et al. 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.CrossRef
23.
Zurück zum Zitat Price D, et al. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respir Med. 2013;107(1):37–46.CrossRefPubMed Price D, et al. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respir Med. 2013;107(1):37–46.CrossRefPubMed
24.
Zurück zum Zitat Sanchis J, Gich I, Pedersen S. Systematic review of errors in inhaler use: has patient technique improved over time? Chest. 2016;150(2):394–406.CrossRefPubMed Sanchis J, Gich I, Pedersen S. Systematic review of errors in inhaler use: has patient technique improved over time? Chest. 2016;150(2):394–406.CrossRefPubMed
25.
Zurück zum Zitat Melani AS, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930–8.CrossRefPubMed Melani AS, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930–8.CrossRefPubMed
26.
Zurück zum Zitat Al-Showair RAM, Pearson SB, Chrystyn H. The potential of a 2 tone trainer to help patients use their metered dose inhalers. Chest. 2007;131(6):1776–82.CrossRefPubMed Al-Showair RAM, Pearson SB, Chrystyn H. The potential of a 2 tone trainer to help patients use their metered dose inhalers. Chest. 2007;131(6):1776–82.CrossRefPubMed
27.
Zurück zum Zitat Voelcker-Rehage C. Motor-skill learning in older adults—a review of studies on age-related differences. Eur Rev Aging Phys Act. 2008;5(1):5–16.CrossRef Voelcker-Rehage C. Motor-skill learning in older adults—a review of studies on age-related differences. Eur Rev Aging Phys Act. 2008;5(1):5–16.CrossRef
28.
Zurück zum Zitat Saeed H, et al. Effect of nebulizer designs on aerosol delivery during non-invasive mechanical ventilation: a modeling study of in vitro data. Pulm Ther. 2017;3(1):233–41.CrossRef Saeed H, et al. Effect of nebulizer designs on aerosol delivery during non-invasive mechanical ventilation: a modeling study of in vitro data. Pulm Ther. 2017;3(1):233–41.CrossRef
29.
Zurück zum Zitat Molimard M, et al. Assessment of handling of inhaler devices in real life: an observational study in 3811 patients in primary care. J Aerosol Med. 2003;16(3):249–54.CrossRefPubMed Molimard M, et al. Assessment of handling of inhaler devices in real life: an observational study in 3811 patients in primary care. J Aerosol Med. 2003;16(3):249–54.CrossRefPubMed
30.
Zurück zum Zitat Rabea H, et al. Modelling of in vitro and in vivo performance of aerosol emitted from different vibrating mesh nebulisers in non-invasive ventilation circuit. Eur J Pharm Sci. 2017;97:182–91.CrossRefPubMed Rabea H, et al. Modelling of in vitro and in vivo performance of aerosol emitted from different vibrating mesh nebulisers in non-invasive ventilation circuit. Eur J Pharm Sci. 2017;97:182–91.CrossRefPubMed
31.
Zurück zum Zitat Hussein RRS, et al. In vitro/in vivo correlation and modeling of emitted dose and lung deposition of inhaled salbutamol from metered dose inhalers with different types of spacers in noninvasively ventilated patients. Pharm Dev Technol. 2017;22(7):871–80.CrossRefPubMed Hussein RRS, et al. In vitro/in vivo correlation and modeling of emitted dose and lung deposition of inhaled salbutamol from metered dose inhalers with different types of spacers in noninvasively ventilated patients. Pharm Dev Technol. 2017;22(7):871–80.CrossRefPubMed
Metadaten
Titel
The Impact of Adding a Training Device to Familiar Counselling on Inhalation Technique and Pulmonary Function of Asthmatics
verfasst von
Mina Nicola
Ahmed Elberry
Ossama Sayed
Raghda Hussein
Haitham Saeed
Mohamed Abdelrahim
Publikationsdatum
15.06.2018
Verlag
Springer Healthcare
Erschienen in
Advances in Therapy / Ausgabe 7/2018
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-018-0737-6

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