This experimental study was conducted to determine the effects of training on inhaler technique and quality of life in patients with chronic obstructive pulmonary disease (COPD).
Methods:
Among the patients who applied at the outpatient clinic of chest diseases between March 2009 and May 2010, a total of 69 with COPD who complied with the criteria of the study were recruited; of these, 34 subjects were put in the intervention group and 35 in the control group. The intervention group was educated on using an inhaler by verbal training, demonstration movie, and leaflet. A follow-up after 3 months was carried out in both groups.
Results:
Of the intervention group, 82.4% used the inhaler correctly; however, in the follow-up, all of the controls used it incorrectly (p<0.05). The number of attacks (p<0.001), emergency applications, and hospitalizations (p>0.05) of the intervention group was lower at the follow-up than in the control. Promotion in all areas of quality of life was determined in the intervention group (p<0.001).
Conclusion:
Consequently, a planned inhaler training given to the patients with COPD was found to decrease attack frequency and dyspnea, and improve quality of life.
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References
1.
CelliBR, MacNeeW. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J, 2004; 23:932–946.
2.
Global Strategy for Diagnosis, Management, Prevention of COPD. 2008September2008. http://www.goldcopd.com. 2012 December 31.
3.
WrightJ, BroclebankFR. Inhaler devices for the treatment of asthma and chronic obstructive airway disease (COPD)Qual Saf Health Care, 2002; 11:376–382.
4.
HesselinkAE, PenninxBWJH, WijnhovenHAH, KriegsmanDMW, EijkJTM. Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scand J Prim Health Care, 2001; 19:255–260.
5.
BashetiIA, ArmourCL, AnticevichSZB, ReddelH. Evaluation of a novel education strategy, including inhaler-based reminder labels to improve asthma inhaler technique. Patient Educ Couns, 2008; 72:26–33.
6.
FinkJB, RubinBK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care, 2005; 50:1360–1373.
7.
RokoskyJM. Teaching correct use of inhaled medications. Home Healthc Nurse, 2005; 23:766–774.
8.
HacıevliyagilSS, ArıkanÖ, GünenH. Inhaler technique of patientsHacettepe UniversityJournal of the Faculty of Pharmacy, 2005; 25:51–60.
9.
ShrestraM, ParupiaMFH, AndrewsB, KimSW, MartinTS, ParkDI, GeeE. Metered-dose inhaler technique of patients in an urban ED: prevalence of incorrect technique and attempt at education. Am J Emerg Med, 1996; 14:380–384.
10.
NewmanSP, BusseWW. Evolution of dry powder inhaler design formulation and performance. Respir Med, 2002; 96:293–304.
LukHH, ChanPM, LamFF, LauKY, ChiuSY, FungYL, PangJ. Teaching chronic obstructive airway disease patients using a metered-dose inhaler. Chin Med J, 2006; 119:1669–1672.
13.
LavoriniF, MagnanA, DubusJC, VoshaarT, CorbettaL, BroedersM, DekhuijzenR, SanchisJ, ViejoJL, BarnesP, CorriganC, LevyM, CromptonGK. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med, 2008; 102:593–604.
14.
GiraudV, RocheN. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J, 2002; 19:246–251.
15.
AbleyC. Teaching elderly patients how to use inhalers. A study to evaluate an education programme on inhaler technique for elderly patients. J Adv Nurs, 1997; 25:699–708.
16.
TakemuraM, KobayashiM, KimuraK, MitsuiK, MasuiH, KoyamaM, ItotaniR, IshitokoM, SuzukiS, AiharaK, MatsumotoM, OgumaT, UedaT, KagiokaH, FukuiM. Repeated training on inhalation technique improves adherence to the therapeutic regimen in asthma. J Asthma, 2010; 47:202–208.
17.
BarnettM. Improving drug concordance in patients with COPD. Nurse Prescribing, 2007; 5:199–204.
18.
ÖzvarışŞB. Health Education and Health Promotion. Hacettepe Public Health Foundation: Ankara, Turkey, 9–10. 2001.
19.
BorgG. Psychophysical basis of perceived exertion. Med Sci Sports Exerc, 1982; 14:377–381.
20.
FletcherCM, ElmesPC, WoodCH. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. Br Med J, 1959; 2:257–266.
21.
JonesPW, QuirkFH, BaveystockCM. The St George's respiratory questionnaire. Respir Med, 1998; 5:25–37.
22.
ÖzkanS, DurnaZ, DemirT, GemicioğluB. Assessment of the functional performance and quality of life in patients with COPD and asthma. Respiration, 2007; 9:158–166.
23.
ToggerD, BrennerPS. Metered dose inhalers. Am J Nurs, 2001; 101:26–32.
24.
BroedersME, SanchisJ, LevyML, CromptonGK, DekhuijzenPN. ADMIT Working Group. The ADMIT series—issues in inhalation therapy 2. Improving technique and clinical effectiveness. Prim Care Respir J, 2009; 18:76–82.
25.
Van der PalenJ, KleinJJ, KerkhoffAH, Van HerwaardenCL, SeydelER. Evaluation of the long-term effectiveness of three training modes for inhaling medicines. Patient Educ Couns, 1997; 32:S87–S95.
26.
HesselinkAE, PenninxBWJH, van der WindtDAWM, van DuinBJ, de VriesP, TwiskJWR, BouterLM, Van EijkJTM. Effectiveness of an education programme by a general practice assistant for asthma and COPD patients: results from a randomised controlled trial. Patient Educ Couns, 2004; 55:121–128.
27.
AbadoğluÖ, YalazkısaS, ÜlgerG, PaşaoğluG, MısırlıgilZ. The role of education by a well-trained nurse on correct utilization of inhalation devices. J Turkish Med Sci J Allergy Asthma, 2003; 5:11–15.
28.
Bosnic-AnticevichSZ, SinhaH, SoS, ReddelHK. Metered-dose inhaler technique: the effect of two educational interventions delivered in community pharmacy over time. J Asthma, 2010; 47:251–256.
SongWS, MullonJ, ReganNA, RothBJ. Training of hospitalized patients by respiratory therapists on metered-dose inhaler use leads to decrease in patient errors. Respir Care, 2005; 50:1040–1045.
31.
DahlR, BackerV, OllgaardB, GerkenF, KestenS. Assessment of patient performance of the HandiHaler compared with the metered dose inhaler four weeks after training. Respir Med, 2003; 97:1126–1133.
32.
NimmoCJR, ChenDNM, MartinusenSM, UstadTL, OstrowDN. Assessment of patient acceptance and inhalation technique of a pressurized aerosol inhaler and two breath-actuated devices. Ann Pharmacother, 1993; 27:922–927.
33.
SouzaMLM, MeneghiniAC, FerrazE, ViannaEO, BorgesMC. Knowledge of and technique for using inhalation devices among asthma patients and COPD patients. J Brasil Pneumol, 2009; 35:824–831.
34.
PlazaV, GinerJ, GomezJ, CasanP, SanchisJ. Health workers' knowledge and skills regarding the use of the Turbuhaler inhaler. Arch Bronconeumol, 1997; 33:113–117.
Van der PalenJ, KleinJJ, KerkhoffAHM, Van HerwaardenCLA. Evaluation of the effectiveness of four different inhalers in patients with chronic obstructive pulmonary disease. Thorax, 1995; 50:1183–1187.
37.
RootmensenGN, Van KeimpemaARJ, JansenHM, HaanRJ. 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; 23:1–6.
38.
MolimardM, RaherisonCS, LignotS, DepontF, AbouelfathA, MooreN. Assessment of handling of inhaler devices in real life: an observational study in 3811 patients in primary care. J Aerosol Med, 2003; 16:249–254.
39.
KhassawnehBY, Al-AliMK, AlzoubiKH. Handling of inhaler devices in actual pulmonary practice: metered-dose inhaler versus dry powder inhalers. Respir Care, 2008; 53:324–328.
40.
WieshammerS, DreyhauptJ. Dry powder inhalers: which factors determine the frequency of handling errors?Respiration, 2008; 75:18–25.
41.
SeemungalTA, DonaldsonGC, PaulEA, BestallJC, JeffriesDJ, JadwigaA, WedzichaJA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 1998; 157:1418–1422.
42.
VerverS, PoelmanM, BogelsA, ChisholmSL, DekkerFW. Effects of training by practice assistants on inhaler technique and respiratory symptoms of patients. A controlled randomized videotaped intervention study. Fam Pract, 1996; 13:35–40.
43.
GürgünA, ErdinçE. Evaluation of Quality of Life in Chronic Obstructive Pulmonary Disease. Chronic Obstructive Pulmonary Disease from Definition to Treatment. Toraks Books: Bursa, Turkey, 374–382. 2008.
44.
GünerA, AtakN. Evaluation of effects of health education on life quality of patients with chronic obstructive pulmonary diseaseAnkara UniversityJournal of the Medical Faculty, 2001; 54:321–332.
