To compare the effectiveness of 4 different instructional interventions in training proper inhaler technique.
Design:
Randomized, noncrossover trial. Setting: Health fair and indigent clinic.
Participants:
Inhaler-naive adult volunteers who spoke and read English.
Interventions:
Subjects were assigned to complete the following: (1) read a metered dose inhaler (MDI) package insert pamphlet, (2) watch a Centers for Disease Control and Prevention (CDC) video demonstrating MDI technique, (3) watch a YouTube video demonstrating MDI technique, or (4) receive direct instruction of MDI technique from a pharmacist.
Primary Outcome:
Inhaler use competency (completion of all 7 prespecified critical steps).
Results:
Of the 72 subjects, 21 (29.2%) demonstrated competent inhaler technique. A statistically significant difference between pharmacist direct instruction and the remaining interventions, both combined (P < .0001) and individually (P ≤ .03), was evident. No statistically significant difference was detected among the remaining 3 intervention groups. Critical steps most frequently omitted or improperly performed were exhaling before inhalation and holding of breath after inhalation.
Conclusion:
A 2-minute pharmacist counseling session is more effective than other interventions in successfully educating patients on proper inhaler technique. Pharmacists can play a pivotal role in reducing the implications of improper inhaler use.
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