CAN INHALER CONFIDENCE PREDICT CORRECT INHALER TECHNIQUE IN PATIENTS?

Objective: Inhaler technique comprises a set of procedures for drug delivery to the respiratory system. The oral inhalation of medications is the first-line treatment for lung diseases. Using the proper inhaler technique ensures sufficient drug deposition in the distal airways, optimizing therapeutic effects and reducing side effects. The purposes of this study were to assess inhaler technique in pediatric and adult patients with asthma; to determine the most common errors in each group of patients; and to compare the results between the two groups. Methods: This was a descriptive cross-sectional study. Using a ten-step protocol, we assessed inhaler technique in 135 pediatric asthma patients and 128 adult asthma patients. Results: The most common error among the pediatric patients was failing to execute a 10-s breath-hold after inhalation, whereas the most common error among the adult patients was failing to exhale fully before using the inhaler. Conclusions: Pediatric asthma patients appear to perform most of the inhaler technique steps correctly. However, the same does not seem to be true for adult patients.

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Inhaler Technique in Asthma: How Does It Relate to Patients' Preferences and Attitudes Toward Their Inhalers?

Journal of Aerosol Medicine and Pulmonary Drug Delivery ◽

10.1089/jamp.2016.1287 ◽

2017 ◽

Vol 30 (1) ◽

pp. 42-52 ◽

Cited By ~ 19

Author(s):

Lia Jahedi ◽

Sue R. Downie ◽

Bandana Saini ◽

Hak-Kim Chan ◽

Sinthia Bosnic-Anticevich

Keyword(s):

Inhaler Technique

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Urinary Excretion Post Inhalation Method to Correlate Inhaler Technique with Disease Control in Patients with Obstructive Pulmonary Diseases Using Own Metered Dose Inhaler (MDI)

10.22541/au.161727102.24108507/v1 ◽

2021 ◽

Author(s):

ethirajan nandagopal ◽

Sumithra M ◽

N Meenakshi

Keyword(s):

Disease Control ◽

Statistical Significance ◽

Pulmonary Diseases ◽

Dose Inhaler ◽

Urinary Concentration ◽

Inhaler Technique ◽

Metered Dose ◽

The Mean ◽

Multiple Drugs ◽

Inhaler Devices

Objectives: Correct use of inhaler devices is critical in ensuring the optimal lung bioavailability of the inhaled drug. The study aimed to assess inhaler technique used in patients with using metered-dose inhalers (MDI) by correlating with urinary salbutamol excretion post inhalation and its correlation with disease control. Methods: Thirty patients with obstructive pulmonary diseases attending outpatients’ services inhaled two doses of salbutamol 100 µg and urine samples were collected after 30 min. Inhaler technique scores were assessed using a standardized 8-point checklist. The 30-minute concentration of urinary salbutamol is then correlated with inhaler technique scores and control status of the disease. Key findings: The mean age of the subjects was 60.8 (SD ± 9.338). The mean (SD) 30 min urinary salbutamol concentration was 3.6±1.6 µg/ml. The mean concentration of salbutamol was found to be 2.3 µg/ml (n=1), 2.3 µg/ml (n=5), 3.1 µg/ml (n=7), 3.9 µg/ml (n=8), 4.7 µg/ml (n=5), 5.3 µg/ml (n=3), and 5.0 µg/ml (n=1) among patients performing 1, 2, 3, 4, 5, 6, 7, 8 steps correctly, respectively. There was a statistically significant correlation (p=0.028) witnessed between the mean 30 min urinary salbutamol concentration and total correct steps. The frequency of exacerbation, use of antibiotics, and oral corticosteroids (OCS) were more in patients with poor inhaler technique scores, although statistical significance was achieved only for frequency of antibiotics use (p=0.032). Conclusions: The 30 min salbutamol urinary concentration evaluation may help to identify patients who were underdosed due to poor handling of inhaler devices. Being a complex procedure, it can at least be initiated in patients reporting frequent exacerbations, hospitalization, and those who need multiple drugs for disease control.

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A Brief Review of Severe Asthma

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v6i2.14942 ◽

2021 ◽

Vol 6 (2) ◽

pp. 4-12

Author(s):

Muhammad Amin Ibrahim ◽

Ahmad Izuanuddin Ismail ◽

Mohammed Fauzi Abdul Rani

Keyword(s):

Severe Asthma ◽

Treatment Options ◽

Oral Steroid ◽

Inhaler Technique ◽

Inhaled Corticosteroid ◽

Asthma Care ◽

Asthmatic Patients ◽

Appropriate Treatment ◽

Considerable Morbidity ◽

The Cost

Severe asthma describes an asthma condition that requires a substantial amount of inhaled corticosteroid and bronchodilators to keep it under control including the frequent additional need for oral steroid to avoid exacerbations. The incidence of severe asthma in Malaysia is unknown but data elsewhere shows that it is around 5 to 10 % of asthmatics. This category of asthmatic patients has considerable morbidity, is disproportionate cost-wise to the number of sufferers and requires specialised and focused care. The management of severe asthma should be undertaken at a severe asthma clinic led by a physician with a special interest in its management. The diagnosis needs confirmation, comorbidities identified and triggering factors addressed. Inhaler technique and compliance are major contributing issues and must be addressed at all consultation opportunities. Once the diagnosis of severe asthma is confirmed, the disease needs phenotyping to plan for the most appropriate treatment, termed as a personalised approach to severe asthma care. The advances in biologics have changed the landscape of treatment of this disease but in Malaysia especially, there are many limitations namely the cost. This article briefly explores the current understanding of severe asthma, the assessment including phenotyping and possible treatment options.

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