Impact of different instructional interventions in training on inhalers amongst Asthma and COPD patients

Abstract

The aim of this study is to assess the impact of different instructional interventions in training on inhalers amongst asthma and COPD patients. A randomized, prospective interventional study was conducted. Different instructional methods were prepared based on guidelines review and expert’s opinion. A total of 210 study participants were included and randomized to different interventions groups such as A. patient information leaflets B. video demonstration C. Direct pharmacist instruction. The inhaler use competency was measured at baseline and after intervention with checklist. Of the 210 subjects, statistically significant differences were observed when compared with the direct pharmacist intervention with other two interventions, for MDI (P-value ˂0.005), MDI with spacer (P-value ˂0.001) and Lupihaler  (P-value ˂0.001). For the Rotahaler  (P-value 0.3), Revoliser  (P-value 0.5) a significant improvement was observed with Direct pharmacist intervention when compared with other two interventions. Different critical steps that were more frequently inappropriately performed are shaking before actuation, breath-out before inhalation, pressing the canister once, hold breath for at least 5-10 seconds, exhaling away from DPI, fast & deep inhalation for DPI. Direct pharmacist instruction has more impact on study participants compared to other interventions in improvement of before and after counselling mean checklist scores, lesser inhaler technique errors were observed when compared with other interventions provided. Other materials can be used along with direct pharmacist intervention for a better understanding of the patients.