CAN PATIENT TRAINING HELP METERED DOSE INHALER TECHNIQUE?

Walid Tarsin*, Hanan Elturki1 and Ishraq Elshamli and Henry Chrystyn

ABSTRACT

Asthma is a chronic inflammatory disease of the airways that affecting millions of people worldwide. Inhaled administration is the mainstay of asthma management and metered dose inhalers (MDIs) are the most widely prescribed inhalation device. Poor disease control and increased hospitalizations is linked to poor inhaler technique. Previous studies to assess inhaler technique have used subjective measures and there is very limited data about the inhalation characteristics used by patients when they use their inhalers. Thus, the aim of this study was to evaluate the effect of counselling of asthmatic patients who use pMDIs on improving their lung function using an inhalation profile recorder. 60 asthmatic patients who attending the outpatient respiratory clinic of Tripoli medical centre (TMC) were recruited to take apart in the study. Their mean (SD) age was 36.67(11.04). Patients divided equally to three group; group one: no counselling, group two: standard counselling (reading leaflets by themselves) and group three: verbal counselling (physical training on the proper use of MDI). The inhalation parameters were recorded by inhalation profile recorder for each patient monthly for 6 months and the lung function was measured at each visit. The mean (SD) of PIF (L/min) before counselling in group one, group two and group three, were 183.63(58.78), 181.79(56.07), 113.89(38.33), respectively, and after counselling was 155.06(51.26), 149.53(53.29) and 88.08(25.89) respectively. An analysis of data revealed a significant different between the mean of PIF pre and post counselling (P = 0.001) for the three different groups. The mean (SD) of Vi/FVC for group, one, two and three were 0.702(0.362), 0.66(0.332) and 0.680(0.653), respectively. Post counselling improvement in PEFR was 20% in group one, 30 % and 60 % in group two and three respectively. 53% of the patients were having good coordination, this percentage was increased when the range of TsIn was increased from 0.00 - 0.20 sec to 0.00 -0.25 sec and 0.00 - 0.30 sec, respectively. In conclusion, verbal counselling and training of asthmatic patients promote the correct inhalation technique and improve their lung function.

Keywords: Inhaled corticosteroids, inhalation flow rate, Inhalation profile recorder, Pressurised Metered Dose Inhalers, Dry Powder Inhalers, Asthma, COPD.