Correcting inhaler technique decreases severity of obstruction and improves quality of life among patients with obstructive airway disease

Background“Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease to determine the core traits associated with disease outcomes, where targeted treatments are applied.ObjectivesTo determine the prevalence of TTs in chronic obstructive pulmonary disease (COPD) and which traits predict future decline in lung function and quality of life (QoL).MethodsA 4 year longitudinal evaluation was conducted using data from 3726 participants in the English Longitudinal Study of Ageing (ELSA). TTs were identified based on published recommendations. Traits that predicted decline in lung function and QoL were analysed using generalised estimating equations.ResultsOverall, 21 TTs, including pulmonary (n=5), extra-pulmonary (n=13) and behavioural/lifestyle risk-factors (n=3) were identified. In multivariate analyses, traits of chronic bronchitis (β=−0.186; 95%CI=−0.290 to −0.082), breathlessness (β=−0.093; 95%CI=−0.164 to −0.022), underweight (β=−0.216; 95%CI=−0.373 to −0.058), sarcopaenia (β=−0.162; 95%CI=−0.262 to −0.061), and current smoking (β=−0.228; 95%CI=−0.304 to −0.153), predicted decline in forced expiratory volume in 1 s (FEV1). Of the seven traits that predicted decline in QoL, depression (β=−7.19; 95%CI=−8.81 to −5.57) and poor family and social support (β=−5.12; 95%CI=−6.65 to −3.59) were the strongest.ConclusionThe core TTs of COPD associated with a decline in lung function and QoL were identified. Targeting these impactful traits and individualised treatment using a precision medicine approach may improve outcomes in people with COPD.

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Incorrect Inhaler Technique Compromising Quality of Life of Asthmatic Patients

Journal of Medicine ◽

10.3329/jom.v13i1.7980 ◽

2012 ◽

Vol 13 (1) ◽

pp. 16-21 ◽

Cited By ~ 13

Author(s):

Anjum Hashmi ◽

Jamil Ahmed Soomro ◽

Afzal Memon ◽

Tahira Kasur Soomro

Keyword(s):

Quality Of Life ◽

Significant Relationship ◽

Sampling Technique ◽

Cross Sectional Study ◽

Education Level ◽

Inhaler Technique ◽

Cross Sectional ◽

Asthmatic Patients ◽

Chest Clinic

Introduction: The inhalation route is widely used for the treatment of asthma. It is considered that inadequate inhaler technique is the leading cause of therapy failure. Objective: To determine the proportion of incorrect inhaler use and associated factors in asthmatic patients compromising quality of life. Methodology: It is a cross sectional study conducted at Specialist Chest Clinic Fatima Bhai Hospital Karachi from September 2010 to March 2011. A sample size of 215 was selected by Non-probability purposive sampling technique. Trained health care workers in presence Chest specialist requested patients to demonstrate their inhaler technique and assessed it according to the checklist. If any of the steps was missing or done incorrectly, it was marked as incorrect technique. Information was also collected through a structured questionnaire on socio-demographic variables such as age, gender, education, duration of asthma, duration of inhaler use, and patient education of inhaler technique. Data was entered and analyzed on SPSS-14. Results: There was an inverse relationship between education level and incorrect inhaler technique (p<0.05). Education of inhaler usage provided by doctors was more effective as compared to education provided by nurses (p<0.038). There was no significant relationship between age, sex, duration of asthma, duration of inhaler use, frequency of inhaler use and incorrect inhaler technique. Conclusion: Quality of life of a large percentage of patients is compromised by incorrect inhaler use and education level of patients had significant relationship with incorrect inhaler technique.DOI: http://dx.doi.org/10.3329/jom.v13i1.7980 JOM 2012; 13(1): 16-21

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Mastery of pMDI technique, asthma control and quality-of-life of children with asthma: A randomized controlled study comparing two inhaler technique training approaches

Pulmonary Pharmacology & Therapeutics ◽

10.1016/j.pupt.2017.02.002 ◽

2017 ◽

Vol 43 ◽

pp. 46-54 ◽

Cited By ~ 8

Author(s):

Wesam G. Ammari ◽

Nussaibah Al-Hyari ◽

Nathir Obeidat ◽

Mona Khater ◽

Amal Sabouba ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Randomized Controlled Study ◽

Controlled Study ◽

Inhaler Technique ◽

Randomized Controlled ◽

Children With Asthma

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The Effects of Training on Inhaler Technique and Quality Of Life in Patients with COPD

Journal of Aerosol Medicine and Pulmonary Drug Delivery ◽

10.1089/jamp.2012.1017 ◽

2013 ◽

Vol 26 (6) ◽

pp. 336-344 ◽

Cited By ~ 30

Author(s):

Songül Göriş ◽

Sultan Taşci ◽

Ferhan Elmali

Keyword(s):

Quality Of Life ◽

Inhaler Technique

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The boundaries of mild chronic obstructive pulmonary disease (COPD): design of the searching clinical COPD onset (SOON) study

BMJ Open ◽

10.1136/bmjopen-2016-015731 ◽

2017 ◽

Vol 7 (8) ◽

pp. e015731 ◽

Cited By ~ 1

Author(s):

Gonzalo Labarca ◽

Andrea Bustamante ◽

Gonzalo Valdivia ◽

Rodrigo Díaz ◽

Álvaro Huete ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Airway Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Peripheral Muscle ◽

Early Grade

IntroductionClinical onset of chronic obstructive pulmonary disease (COPD) is the point at which the disease is first identifiable by physicians. It is a poorly defined stage which seems to include both mild spirometric and non-spirometric disease, and could be described as early grade COPD, for practical purposes. While dyspnoea; chronic bronchitis and CT imaging evidence of emphysema and airway disease may be present very early, the lone significance of dyspnoea, the most relevant symptom in COPD in identifying these individuals, has been scarcely assessed.The Searching Clinical COPD Onset (SOON) Study was designed primarily to detect clinical, physiological and structural differences between dyspnoeic and non-dyspnoeic individuals with early grade COPD. It is hypothesised that presence of dyspnoea in early disease may identify a subtype of individuals with reduced exercise capacity, notwithstanding of their spirometry results. In addition, dyspnoeic individuals will share worse quality of life, lower physical activity, greater lung hyperinflation greater emphysema and airway thickness and reduced peripheral muscle mass than their non-dyspnoeic counterpart.Methods and analysisSOON is a monocentric study, with a cross sectional design aimed at obtaining representative samples of current or ex-smoker-adults aged ≥45 and ≤80 years. Two hundred and forty participants will be enrolled into four strata, according to normal spirometry or mild spirometric obstruction and presence or not of dyspnoea modified Medical Research Council score ≥1. The primary outcome will be the difference between dyspnoeic and non-dyspnoeic individuals on the 6-min walk test performance, regardless of their spirometry results. To account for the confounding effect of heart failure on dyspnoea, stress echocardiography will be also performed. Secondary outcomes will include clinical (quality of life, physical activity), physiological (exercise testing) and structural characteristics (emphysema, airway disease and peripheral muscle mass by CT imaging).Ethics and disseminationThe Institutional Ethics Committee from Pontificia Universidad Católica de Chile has approved the study protocol and signed informed consent will be obtained from all participants. The findings of the trial will be disseminated through relevant peer-reviewed journals and international conference presentations.Trial registration numberNCT03026439.

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The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care

Chronic Respiratory Disease ◽

10.1177/1479972317723237 ◽

2017 ◽

Vol 15 (2) ◽

pp. 103-113 ◽

Cited By ~ 2

Author(s):

Jean Bourbeau ◽

Raquel Farias ◽

Pei Zhi Li ◽

Guylaine Gauthier ◽

Livia Battisti ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Treatment Adherence ◽

Educational Intervention ◽

Primary Care Physicians ◽

Management Education ◽

Action Plan ◽

Self Management ◽

Inhaler Technique

The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offered by trained case managers who focused on treatment adherence, inhaler techniques, smoking cessation, and the use of an action plan for exacerbations. Health-care utilization, health-related quality of life (HRQL), treatment adherence, inhaler technique, and COPD knowledge were assessed at each visit with validated questionnaires. We also evaluated whether the use of spirometry and the assessment of individual patient needs led to a more COPD-targeted treatment by primary care physicians, based on changes in prescriptions for COPD (medication, immunization, and written action plan). Fifty-four patients completed the follow-up visits and were included in the analysis. The number of unscheduled physician visits went from 40 the year before intervention to 17 after 1 year of educational intervention ( p = 0.033). Emergency room visits went from five to two and hospitalizations from two to three (NS). Significant improvements were observed in HRQL ( p = 0.0001), treatment adherence ( p = 0.025), adequate inhaler technique ( p < 0.0001), and COPD knowledge ( p < 0.001). Primary care physicians increased their prescriptions for long-acting bronchodilators with/without inhaled corticosteroid, flu immunizations, and COPD action plans in the event patient had an exacerbation. The COPD self-management educational intervention in FMCs reduced unscheduled visits to the clinic and improved patients’ quality of life, self-management skills, and knowledge. The program had a positive impact on COPD-related practices by primary care physicians in the FMCs.

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