Inhaler device usage skills in patients at pulmonology clinics

Abstract

Aim: In the treatment of obstructive lung diseases, large number of drugs (both bronchodilator and antiinflammatory drugs) have been used by inhalation. Due to the errors made during inhaler drug administration patients either don’t take targeted doses, or even any medication. In the present study we aimed to determine factors affecting the correct use of inhaler devices.

Materials and Method: Patients who were followed up in Ümraniye Training and Research Hospital Chest Diseases Department between 01.06.2010- 30.12.2010 for asthma and/or chronic obstructive pulmonary disease were retrospectively evaluated. All the patients received inhaler drug treatment previously. The ability to use inhaler drugs and causative factors for improper use were investigated. The study included 751 patients (M/F:254/497). Patients’ age, gender, education level, duration of symptoms and the devices used were achieved from the records. Using skills were evaluated according to the chart prepared by the Turkish Respiratory Society ‘Inhalation Therapies’ Working Study Group.

Results: Seventy-four percent of patients were using their drugs correctly. Correct utilization rate was 66,3% for Metered Dose Inhaler (MDI) and, it was ranged from 76-81% for Dry Powder Inhaler (DPI) (p=0.030, p<0.05). Advanced age (>60 years old), to be literate or graduated from primary school, duration of symptoms (< 3 months), and MDI device selection were affecting improper use. There was no statistically significant difference between genders for device use. Effects of age, education, duration of symptoms on the improper use of MDI devices were evaluated by backward stepwise logistic regression analysis. Advanced age (> 60 years old), to be literate or being graduated from primary school, duration of symptoms (< 3 months) and MDI device use increased the risk by 3, 4,6, 17,5 and 1,8 times respectively.

Conclusion: We concluded that in the presence of conditions necessitating the use of inhalers, the devices easy to use should be preferred regarding the age, education level and the skill of the patient. Practical inhaler device training should be given and assessed during follow-up visits.