Matching the Inhaler to the Patient in COPD

Selecting the most appropriate inhalation device from the wide range available is essential for the successful management of patients with chronic obstructive pulmonary disease. Although choice is good for healthcare professionals, knowing which inhaler to prescribe is a complex consideration. Among the key factors to consider are quality of disease control, inhaler technique, inhaler resistance and inspiratory flow, inhaler design and mechanisms of drug delivery, insurance and reimbursement restrictions, and environmental impact. In this article, we offer a simple, practical tool that brings together all these factors and includes hyperlinks to other published resources from the United Kingdom, Belgium, and The Netherlands.

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Is Inhaler Technique Associated with Quality of Life in Patients with Chronic Obstructive Pulmonary Disease?

Current Therapeutic Research ◽

10.1016/j.curtheres.2020.100608 ◽

2020 ◽

Vol 93 ◽

pp. 100608

Author(s):

Shahideh Amini ◽

Arezou Ghasemi ◽

Mohammad Solduzian ◽

Besharat Rahimi ◽

Kazem Heidari ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Inhaler Technique ◽

Obstructive Pulmonary Disease

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Teaching inhaler technique

Journal of Prescribing Practice ◽

10.12968/jprp.2020.2.5.234 ◽

2020 ◽

Vol 2 (5) ◽

pp. 234-237 ◽

Cited By ~ 1

Author(s):

Jane Scullion

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Side Effects ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Simple Approach ◽

Chronic Obstructive ◽

Inhaler Technique ◽

Obstructive Pulmonary Disease ◽

Practical Advice

Inhalers were developed to deliver required medications directly to the lungs whilst minimising any side effects. They are the key to managing exacerbations and symptoms in both asthma and chronic obstructive pulmonary disease but are not yet proven to prevent mortality in the later. Disappointingly, the evidence still shows that many healthcare professionals cannot use them and therefore cannot correctly instruct patients in their use, and that patients are still unable to maximise the benefits they could get from their inhalers because of poor technique and adherence. The following article discusses the issues and offers a simple approach and practical advice on teaching inhaler techniques. It concludes that maybe it is time for us to think differently to teach inhaler technique and use effectively.

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Spirometry in Primary Care

Canadian Respiratory Journal ◽

10.1155/2013/615281 ◽

2013 ◽

Vol 20 (1) ◽

pp. 13-22 ◽

Cited By ~ 32

Author(s):

Allan L Coates ◽

Brian L Graham ◽

Robin G McFadden ◽

Colm McParland ◽

Dilshad Moosa ◽

...

Keyword(s):

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Position Statement ◽

Accreditation Process ◽

Chronic Obstructive ◽

Key Factors ◽

Obstructive Pulmonary Disease ◽

Factors Affecting

Canadian Thoracic Society (CTS) clinical guidelines for asthma and chronic obstructive pulmonary disease (COPD) specify that spirometry should be used to diagnose these diseases. Given the burden of asthma and COPD, most people with these diseases will be diagnosed in the primary care setting. The present CTS position statement was developed to provide guidance on key factors affecting the quality of spirometry testing in the primary care setting. The present statement may also be used to inform and guide the accreditation process for spirometry in each province.Although many of the principles discussed are equally applicable to pulmonary function laboratories and interpretation of tests by respirologists, they are held to a higher standard and are outside the scope of the present statement.

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The effects of repeated inhaler device handling education in COPD patients: a prospective cohort study

Scientific Reports ◽

10.1038/s41598-020-76961-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

June Hong Ahn ◽

Jin Hong Chung ◽

Kyeong-Cheol Shin ◽

Hyun Jung Jin ◽

Jong Geol Jang ◽

...

Keyword(s):

Quality Of Life ◽

Practice Nurse ◽

Chronic Obstructive ◽

Advanced Practice ◽

Advanced Practice Nurse ◽

Inhaler Technique ◽

Obstructive Pulmonary Disease ◽

Face To Face ◽

Copd Patients

AbstractInhaler education for chronic obstructive pulmonary disease (COPD) patients improves inhaler technique and adherence. However, the effects of such education on the quality of life and inhaler satisfaction remain unclear. Here, we evaluated inhaler handling and adherence, and changes in quality of life and inhaler satisfaction, after repeated education for COPD patients. We prospectively enrolled COPD patients who had used inhalers for over 1 month and evaluated the effects of repeated education. Three visits were made over 6 months; an advanced practice nurse evaluated inhaler technique and adherence, and instructed the patients in inhaler technique during face-to-face sessions. Inhaler technique and adherence were assessed at every visits, and the modified Medical Research Council (mMRC) test, COPD Assessment Test (CAT), EuroQol-5D (EQ-5D), Patient Health Questionnaire (PHQ-9), and Feeling of Satisfaction with Inhaler questionnaire (FSI-10) were administered before (visit 1) and after two educational sessions (visit 3). A total of 261 COPD patients (308 inhalers) were included. Education significantly reduced the proportion of critical errors after two educational sessions (visit 3), from 43.2 to 8.8% (p < 0.001). The proportion of highly compliant patients increased after two visits, from 81.6% to 87.7% (p = 0.005). The FSI-10 score improved significantly after education, from 44.36 ± 4.69 to 47.64 ± 4.08 (p < 0.001); the scores on the other instruments (mMRC, CAT, EQ-5D, and PHQ-9) did not improve. Repeated face-to-face inhaler education by an advanced practice nurse significantly improved inhaler satisfaction, technique, and adherence. However, inhaler education did not significantly improve quality of life.

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