scholarly journals Empowering Family Physicians to Impart Proper Inhaler Teaching to Patients with Chronic Obstructive Pulmonary Disease and Asthma

2015 ◽  
Vol 22 (5) ◽  
pp. 266-270 ◽  
Author(s):  
Janice M Leung ◽  
Mohit Bhutani ◽  
Richard Leigh ◽  
Dan Pelletier ◽  
Cathy Good ◽  
...  

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) and asthma depend on inhalers for management, but critical errors committed during inhaler use can limit drug effectiveness. Outpatient education in inhaler technique remains inconsistent due to limited resources and inadequate provider knowledge.OBJECTIVE: To determine whether a simple, two-session inhaler education program can improve physician attitudes toward inhaler teaching in primary care practice.METHODS: An inhaler education program with small-group hands-on device training was instituted for family physicians (FP) in British Columbia and Alberta. Sessions were spaced one to three months apart. All critical errors were corrected in the first session. Questionnaires surveying current inhaler teaching practices and attitudes toward inhaler teaching were distributed to physicians before and after the program.RESULTS: Forty-one (60%) of a total 68 participating FPs completed both before and after program questionnaires. Before the program, only 20 (49%) reported providing some form of inhaler teaching in their practices, and only four (10%) felt fully competent to teach patients inhaler technique. After the program, 40 (98%) rated their inhaler teaching as good to excellent. Thirty-four (83%) reported providing inhaler teaching in their practices, either by themselves or by an allied health care professional they had personally trained. All stated they could teach inhaler technique within 5 min. Observation of FPs during the second session by certified respiratory educators found that none made critical errors and all had excellent technique.CONCLUSION: A physician inhaler education program can improve attitudes toward inhaler teaching and facilitate implementation in clinical practices.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian-lan Hua ◽  
Xiao-fen Ye ◽  
Chun-ling Du ◽  
Ning Xie ◽  
Jie-qing Zhang ◽  
...  

Abstract Background Pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs) are commonly used drug-delivering devices for patients with chronic airway diseases. Appropriate peak inhalation flow rate (PIFR) and inhaler technique is essential for effective therapy. We aimed at optimizing inhalation therapy through the analysis of PIFRs in patients with chronic obstructive pulmonary disease (COPD) or asthma as well as the effect of technique training using In-Check DIAL® to help patients to achieve their optimal inspiratory flow rates. Methods The study continuously enrolled patients who were diagnosed as COPD or asthma from respiratory clinics. PIFRs were described and analyzed between the newly-diagnosed and follow-up patients, and the stable and acute exacerbation patients, respectively. Every participant was trained inhaler technique using In-Check DIAL®. PIFRs before and after training was compared by self-control analysis. Results Among a total of 209 patients, the average age was 56.9 years. For DPIs users, 10.8% patients had a PIFR < 30 L/min and 44.1% patients had a PIFR ≥ 60 L/min before technique training. After technique training, scarcely patient (1.5%) had a PIFR < 30 L/min, and 60.5% patients had a PIFR ≥ 60 L/min. The patient’s average PIFR increased by 5.6L/min after training. The increase in PIFR before and after training was significant (p < 0.001) for most patients, but no significant variation was found in patients with acute exacerbation (p = 0.822). Conclusions A considerable number of patients with COPD or asthma were not able to achieve the minimum or optimal PIFR for DPIs. Inhaler training can increase patients’ PIFRs and improve their ability to use DPIs. Trail registration The study has registered in chictr.org.cn (ChiCTR1900024707) and been approved by the Ethics Committee of Zhongshan Hospital of Fudan University (B2019-142).


2014 ◽  
Vol 21 (1) ◽  
pp. 47-52
Author(s):  
Cecília Rossatto Facco ◽  
Juliana Corrêa Soares ◽  
Carlos Bolli Mota ◽  
Maria Elaine Trevisan

The objective of this study was to evaluate the functionality of gait and cardiorespiratory parameters in individuals with chronic obstructive pulmonary disease (COPD), before and after a walk test, in order to allow the development of strategies, aimed at maintaining autonomy and preservation of independence. In this study, were included individuals with COPD, aged between 50 to 80 years, and excluded those with orthopedic, neurological and cardiac problems, or any condition that would prevent the assessments proposed in this study. The variables measured were:1st peak force, mid peak low and 2nd peak force, time of 1st double support, the swing moment and 2nd double support; single support time, stride length and stride, speed and time gait cycle, heart rate, oxygen saturation and dyspnea/tiredness score, pre and post-test. The sample consisted of 14 individuals (8 females and 6 males), mean age 65.21±9.42 years. In the post-test patients had greater sensation of dyspnea / fatigue, increased speed and reduced time of the gait cycle, increase the 1st peak force and reduction of the mid peak low, reduction the time the 1st double support and the time of the 1st peak force. The physical effort had influenced the gait pattern and cardiorespiratory parameters in this group of individuals with COPD.


2019 ◽  
Vol 69 (1) ◽  
pp. 149-157 ◽  
Author(s):  
Sebastian Rutkowski ◽  
Anna Rutkowska ◽  
Dariusz Jastrzębski ◽  
Henryk Racheniuk ◽  
Witold Pawełczyk ◽  
...  

Abstract The aim of the study was to evaluate the effects of rehabilitation in patients with chronic obstructive pulmonary disease (COPD) using the Kinect system during stationary rehabilitation. The study included 68 patients with COPD (35 men, 33 women, mean age 61.3 ± 3.7). The subjects were randomly assigned to one of the two experimental groups described below. Group I included 34 patients – non‐participants in Kinect training. Group II included 34 patients – participants in Kinect training. In all patients before and after rehabilitation physical fitness was assessed using the Senior Fitness Test (SFT). The Xbox 360 and Kinect motion sensor were used to carry out virtual reality training. In group I, statistically significant improvements in SFT performance were observed. Patients in group II also showed statistically significant improvement in physical fitness in all attempts of the SFT. Virtual rehabilitation training in patients with COPD seems to be a practical and beneficial intervention capable of enhancing mobility and physical fitness.


2019 ◽  
Vol 7 (01) ◽  
pp. 28
Author(s):  
Nury Nusdwinuringtyas ◽  
Siti Chandra Widjanantie

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance


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