Effectiveness of Nurse-Driven Inhaler Education on Inhaler Proficiency and Compliance Among Obstructive Lung Disease Patients: A Quasi-Experimental Study
Restricted accessResearch articleFirst published online June, 2016
Effectiveness of Nurse-Driven Inhaler Education on Inhaler Proficiency and Compliance Among Obstructive Lung Disease Patients: A Quasi-Experimental Study
Health education on proper inhaler usage is the most feasible and accessible strategy to increase inhaler effectiveness.
Purpose
To assess the impact of nurse-driven inhaler education on the compliance and proficiency of using inhalers among inhaler users.
Methods
This single-center, quasi-experimental study included the implementation of an individualized 60-min educational session on inhalers use. Health education and pretest and posttest outcomes were assessed by the Inhaler Proficiency Schedule and Patient Reported Behaviour tools.
Results
One hundred and twenty-one participants joined the study. At pretest, participants showed inadequate knowledge of general inhaler use. No previous training had been received by participants and difficulty with use and complications from using the inhalers were reported. At posttest, participants reported improvement in inhaler proficiency scores from 5.72 to 8.60 (t = 17.99, df = 220, p < 0.001). Likewise, they showed a significant reduction towards the noncompliant behaviors from 15.21 to 11.19 (t = 16.388, df = 238, p < 0.001).
Conclusions
Nurse-driven inhaler education yielded positive outcomes in both inhaler proficiency and compliance. The patients' assessment of using inhalers is crucial to determine the patients' educational deficits.
AkinbamiL. J.MoormanJ. E.LiuX. (2011) Asthma prevalence, health care use, and mortality: United States, 2005–2009. National Health Statistics Report12(32): 1–14.
2.
Al-JahdaliH.AhmedA.Al-HarbiA.KhanM.BaharoonS.Bin SalihS.Al-MuhsenS. (2013) Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy, Asthma & Clinical Immunology9(1): 8.
3.
AL-JahdaliH.AnwarA.AL-Harbi1A.BaharoonS.HalwaniR.Al ShimemeriA.Al-MuhsenS. (2012) Factors associated with patient visits to the emergency department for asthma therapy. BMC Pulmonary Medicine17(12): 1–7.
4.
BondsR.AsawaA.GhaziA. (2015) Misuse of medical devices: A persistent problem in self-management of asthma and allergic disease. Annals of Allergy, Asthma & Immunology114(1): 74–76.
5.
BraidoF.BaiardiniSumberesiM.BlasiF.CanonicaG. W. (2013) Obstructive lung diseases and inhaler treatment: Results from a national public pragmatic survey. Respiratory Research14(94): 1–8.
6.
ChoiJ. Y.ChungC. H. (2010) Effect of an individualised education programme on asthma control, inhaler use skill, asthma knowledge and health-related quality of life among poorly compliant Korean adult patients with asthma. Journal of Clinical Nursing20: 119–126.
7.
ChrystynaH.PriceaD. (2009) Not all asthma inhalers are the same: Factors to consider when prescribing an inhaler. Primary Care Respiratory Journal18(4): 243–249.
8.
EldhA. C.EhnforsM.EkmanI. (2006) The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure. European Journal of Cardiovascular Nursing5(1): 45–53.
9.
FangX.LiS.GaoL.ZhaoN.WangX.BaiC. (2012) A short-term educational program improved physicians' adherence to guidelines for COPD and asthma in Shanghai. Clinical and Translational Medicine1(1): 13.
10.
FribergF.AnderssonE. P.BengtssonJ. (2007) Pedagogical encounters between nurses and patients in a medical ward—A field study. International Journal of Nursing Studies44: 534–544.
11.
GáLffyG.MezeiG.NéMethTamásiL.MullerV.SelroosO.OroszM. (2013) Inhaler competence and patient satisfaction with Easyhaler®: Results of two real-life multicentre studies in asthma and COPD. Drugs in R&D13(3): 215–222.
12.
HaleE. M.CostelloR. W.CowmanS. (2014) A nurse-led intervention study: Promoting compliance with Diskus Inhaler use in asthma patients. Nursing Open1(1): 42–50.
13.
LeeH.BooS.LimY.KimS.KimI. (2014) Accuracy of inhaler use in patients with chronic obstructive pulmonary disease. Clinical Nursing Research23(5): 560–574.
14.
LeeS. M.ChangY. S.KimC. W.KimT. B.KimS. H.KwonY. E.JeeY. K. (2011) Skills in handling turbuhaler, diskus, and pressurized metered-dose inhaler in Korean asthmatic patients. Allergy, Asthma & Immunology Research3(1): 46–52.
15.
Leiva-FernándezF.Leiva-FernándezJ.Zubeldia-SantoyoF.García-RuizA.Prados-TorresD.Barnestein-FonsecaP. (2012) Efficacy of two educational interventions about inhalation techniques in patients with chronic obstructive pulmonary disease (COPD). TECEPOC: Study protocol for a partially randomized controlled trial (preference trial). Trials13: 64.
16.
Mac Hale, E., & Cowman, S. (2012a). Inhaler Proficiency Schedule (IPS) (Unpublished MSc thesis). Royal College of Surgeons in Ireland, Dublin.
17.
Mac Hale, E., & Cowman, S. (2012b). Patient Reported Behaviour Questionnaire (PRB) (Unpublished MSc thesis), Royal College of Surgeons in Ireland, Dublin.
18.
MelaniA. S.BonaviaM.CilentiV.CintiC.LodiM.MartucciP.NeriM. (2011) Inhaler mishandling remains common in real life and is associated with reduced disease control. Respiratory Medicine105(6): 930–938.
19.
MolimardM.RaherisonC.LignotS.DepontF.AbouelfathA.MooreN. (2003) Assessment of handling of inhaler devices in real life: An observational study in 3811 patients in primary care. Journal of Aerosol Medicine16(3): 249–254.
20.
NeiningerM. P.KauneA.BertscheA.RinkJ. J.MusiolJ.FrontiniR.BertscheT. (2015) How to improve prescription of inhaled salbutamol by providing standardised feedback on administration: A controlled intervention pilot study with follow-up. BMC Health Services Research15(40): 1–7.
21.
RabeK. F.HurdS.AnzuetoA.BarnesP. J.BuistS. A.CalverleyP.ZielinskiJ. (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine176: 532–555.
22.
ReznikM.JaramilloY.Wylie-RosettJ. (2014) Demonstrating and assessing metered-dose inhaler-spacer technique: Pediatric care providers' self-reported practices and perceived barriers. Clinical Pediatrics (Phila)53(3): 270–276.
23.
RootmensenG. N.Van KeimpemaA. R.JansenH. M.De HaanR. J. (2010) Predictors of incorrect inhalation technique in patients with asthma or COPD: A study using a validated videotaped scoring method. Journal of Aerosol Medicine and Pulmonary Drug Delivery23(5): 323–328.
24.
SanderN.Fusco-WalkertS. J.HarderJ. M.ChippsB. E. (2006) Efficacy of metered-dose inhaler. Annals of Allergy, Asthma & Immunology97: 34–38.
25.
SeheultJ. N.CostelloS.TeeK. C.BholahT.Al BannaiH.SulaimanI.CostelloR. W. (2014) Investigating the relationship between peak inspiratory flow rate and volume of inhalation from a Diskus™ Inhaler and baseline spirometric parameters: A cross-sectional study. SpringerPlus3: 496.
26.
SuissaS. (2003) Effectiveness of inhaled corticosteroids in chronic obstructive pulmonary disease: Immortal time bias in observational studies. American Journal of Respiratory and Critical Care Medicine168: 49–53.
27.
SvedsaterH.DaleP.GarrillK.WalkerR.WoepseM. W. (2013) Qualitative assessment of attributes and ease of use of the ELLIPTA™ dry powder inhaler for delivery of maintenance therapy for asthma and COPD. BMC Pulmonary Medicine13: 72.
28.
UijenJ. H.Van UijthovenY. J.Van der WoudenJ. C.BindelsP. J. (2009) Adequate use of asthma inhalation medication in children: More involvement of the parents seems useful. BMC Research Notes2: 129.
