scholarly journals An evaluation of proper inhaler technique and adherence to treatment in asthma patients

2019 ◽  
Vol 7 (6) ◽  
pp. 2382
Author(s):  
Abdul Hashim K. P. ◽  
Muhammed Anas Ayoob
Keyword(s):  
Elderly Patients ◽  
Inhaler Technique ◽  
Inhaled Corticosteroid ◽  
Adherence To Treatment ◽  
Demographic Information ◽  
Therapeutic Advantage ◽  
Medication Delivery ◽  
Asthma Patients ◽  
Inhaler Devices ◽  
Effective Medication

Background: Medications used to manage Asthma is delivered via inhaler devices. Proper usage of these devices are required for effective medication delivery. Aim of this study is assess the degree of proper inhaler technique and adherence to treatment among adult asthma patients.Methods: Patients using inhalers were identified and interviewed regarding inhaler use. Checklists were used to document the adherence to manufacturers’ directions for each respective inhaler, and data were then tabulated and assessed for the types of inhalers used, incorrectly performed steps in using the inhalers, as well as demographic information of patients.Results: Out of 120 patients that taken as subjects, twenty-four percent of inhalers (29/120) used incorrectly, with the most common errors being improper priming, lack of proper exhalation prior to inhaling the medication, and absence of rinsing mouth following the use of inhaled corticosteroid. Furthermore, only 60% of the patients are adherent to asthma medications.Conclusions: Inhaler technique among adult patients is substandard and is considered a key area for physicians to more proactive in educating patients. For obtaining most accurate therapeutic advantage among patients with inhalers, proper instruction and demonstration regarding inhaler use need to be given to all patients, particularly elderly patients.

Is there potential to use augmented reality technology to provide demonstrative inhaler technique education for asthma patients? A qualitative study (Preprint)

2021 ◽  
Author(s):  
Zoe Kopsaftis ◽  
Antonia O'Connor ◽  
Kelsey Jayne Sharrad ◽  
Charmaine King ◽  
Assoc. Prof. Carson-Chahhoud
Keyword(s):  
Augmented Reality ◽  
Disease Management ◽  
Health Professionals ◽  
Clinical Care ◽  
Service Utilisation ◽  
Inhaler Technique ◽  
Community Stakeholders ◽  
Asthma Patients ◽  
Augmented Reality Technology ◽  
Inhaler Devices

BACKGROUND Many people with asthma use incorrect inhaler technique resulting in sub-optimal disease management and increased health service utilisation. Novel ways of delivering appropriate instructions are needed. OBJECTIVE This study explores stakeholder perspectives on the potential use of augmented reality (AR) technology to improve asthma inhaler technique education. METHODS Based on existing evidence and resources, an information poster displaying the images of 22 asthma inhaler devices was produced. Using AR technology via a free smartphone application, the poster launched video demonstrations of correct inhaler technique for each device. Twenty‐one semi‐structured, one‐on‐one interviews with health professionals, people with asthma and key community stakeholders were conducted and data was analysed thematically using the Triandis model of interpersonal behaviour. RESULTS People with asthma believed they were competent with inhaler technique. However, health professionals and key community stakeholders identified that this perception was misguided and facilitates persistent incorrect inhaler use and sub‐optimal disease management. Delivering inhaler technique education using augmented reality was favoured by all participants, particularly around ease of use, with the ability to visually display inhaler techniques for each device. However, all participants identified some barriers, particularly for access and appropriateness of AR for older people. CONCLUSIONS Augmented reality technology may be a novel means to address poor inhaler technique among certain cohorts of asthma patients and serve as a prompt for health professionals to initiate review of inhaler devices. A randomised controlled trial design is needed to evaluate efficacy of this technology for use in the clinical care setting.

Omalizumab versus Mepolizumab as add-on therapy in asthma patients not well controlled on at least an inhaled corticosteroid: A network meta-analysis

2017 ◽  
Vol 55 (1) ◽  
pp. 89-100 ◽  
Author(s):  
Zahi Nachef ◽  
Amita Krishnan ◽  
Terry Mashtare ◽  
Tingting Zhuang ◽  
M. Jeffery Mador
Keyword(s):  
Meta Analysis ◽  
Inhaled Corticosteroid ◽  
Asthma Patients

scholarly journals Study of inhaler technique in asthma patients: differences between pediatric and adult patients

2015 ◽  
Vol 41 (5) ◽  
pp. 405-409 ◽  
Author(s):  
Pablo Manríquez ◽  
Ana María Acuña ◽  
Luis Muñoz ◽  
Alvaro Reyes
Keyword(s):  
Pediatric Asthma ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Breath Hold ◽  
Therapeutic Effects ◽  
Inhaler Technique ◽  
Cross Sectional ◽  
Common Error ◽  
Oral Inhalation ◽  
Asthma 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.

scholarly journals Comparison of Salbutamol Delivery Efficiency for Jet versus Mesh Nebulizer Using Mice

Pharmaceutics ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 192 ◽  
Author(s):  
Chang ◽  
Moon ◽  
Oh ◽  
Yoon ◽  
Gu ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Aerosol Particles ◽  
Clinical Validation ◽  
Output Rate ◽  
Medication Delivery ◽  
Jet Nebulizer ◽  
Jet Nebulizers ◽  
Effective Medication ◽  
Delivery Efficiency ◽  
Better Than

Recent reports using a breathing simulator system have suggested that mesh nebulizers provide more effective medication delivery than jet nebulizers. In this study, the performances of jet and mesh nebulizers were evaluated by comparing their aerosol drug delivery efficiencies in mice. We compared four home nebulizers: two jet nebulizers (PARI BOY SX with red and blue nozzles), a static mesh nebulizer (NE-U22), and a vibrating mesh nebulizer (NE-SM1). After mice were exposed to salbutamol aerosol, the levels of salbutamol in serum and lung were estimated by ELISA. The residual volume of salbutamol was the largest at 34.6% in PARI BOY SX, while the values for NE-U22 and NE-SM1 mesh nebulizers were each less than 1%. The salbutamol delivery efficiencies of NE-U22 and NE-SM1 were higher than that of PARI BOY SX, as the total delivered amounts of lung and serum were 39.9% and 141.7% as compared to PARI BOY SX, respectively. The delivery efficiency of the mesh nebulizer was better than that of the jet nebulizer. Although the jet nebulizer can generate smaller aerosol particles than the mesh nebulizer used in this study, the output rate of the jet nebulizer is low, resulting in lower salbutamol delivery efficiency. Therefore, clinical validation of the drug delivery efficiency according to nebulizer type is necessary to avoid overdose and reduced drug wastage.

Impact of adherence to treatment with fluticasone propionate/salmeterol in asthma patients

2014 ◽  
Vol 30 (7) ◽  
pp. 1417-1425 ◽  
Author(s):  
A. Ismaila ◽  
D. Corriveau ◽  
J. Vaillancourt ◽  
D. Parsons ◽  
R. Stanford ◽  
...  
Keyword(s):  
Fluticasone Propionate ◽  
Adherence To Treatment ◽  
Asthma Patients

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

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.

scholarly journals A Brief Review of Severe Asthma

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.

scholarly journals The Challenge of Delivering Therapeutic Aerosols to Asthma Patients

ISRN Allergy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Federico Lavorini
Keyword(s):  
Asthma Management ◽  
Dose Inhaler ◽  
Inhalation Technique ◽  
Management Guidelines ◽  
Inhaler Device ◽  
Peripheral Airways ◽  
Metered Dose ◽  
Asthma Patients ◽  
Patient Noncompliance ◽  
Inhaler Devices

The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.

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