scholarly journals Can a Short Video Improve Inhaler Use in Urban Youth?

2017 ◽  
Vol 22 (4) ◽  
pp. 293-299 ◽  
Author(s):  
Sara Brown ◽  
Victoria Tutag Lehr ◽  
Nathan French ◽  
Christopher Alan Giuliano
Keyword(s):  
African American ◽  
Asthma Control ◽  
Urban Youth ◽  
Medical Center ◽  
Composite Score ◽  
Lead Author ◽  
Dose Inhaler ◽  
Inpatient Setting ◽  
Inhaler Technique ◽  
Short Video

OBJECTIVE The primary aim was to determine whether watching a short video in the inpatient setting could produce an immediate improvement in pediatric patients' asthma knowledge and inhaler technique. METHODS This prospective, quasi-experimental, pre-post study was conducted in a single center, in Detroit, Michigan, which primarily serves an urban, African-American population. Patients were eligible if they were between 8- and 16-years-old, had asthma, and would be discharged with an albuterol metered-dose inhaler. The primary outcome was improvement in the composite score of a knowledge and technique assessment before and after watching a 5-minute video. The lead author developed the video with content validation by pharmacists, pediatricians, elementary school teachers, and a pediatric health education specialist. Secondary outcomes at 30 days included change in asthma control and whether the video was revisited after discharge. RESULTS Thirty patients were enrolled. Their average age was 11 ± 2.1 years; they were primarily African American (83%), female (53%), and insured by Medicaid (87%). The composite score of technique assessment and written quiz increased by 3.53 (95% confidence interval [CI] 2.81 to 4.85) of a possible 16 points after watching the video. There was no significant change in asthma control at 30 days as measured by the asthma control test (2, 95% CI −0.53 to 4.53). Eight of 22 patients revisited the video after discharge. CONCLUSIONS A brief educational video delivered during a pediatric inpatient visit in an urban medical center resulted in an immediate improvement in patients' disease knowledge and inhaler technique.

scholarly journals Assessment of Novel Inhaler Technique Reminder Labels in Image Format on the Correct Demonstration of Inhaler Technique Skills in Asthma: A Single-Blinded Randomized Controlled Trial

2021 ◽  
Vol 14 (2) ◽  
pp. 150
Author(s):  
Iman Basheti ◽  
Bassam Mahboub ◽  
Laila Salameh ◽  
Mena Al-Ani ◽  
Ammar Abdulrahman Jairoun ◽  
...  
Keyword(s):  
Asthma Control ◽  
Educational Intervention ◽  
Active Group ◽  
Controlled Study ◽  
Dose Inhaler ◽  
Control Group ◽  
Inhaler Technique ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Image Format

Background: Prevalence of asthma in the United Arab Emirates (UAE) is high, and training patients on correct inhaler technique is vital. Objectives: To assess the effectiveness of inhaler technique labels incorporating the individual technique steps in image format on the retention of correct inhaler technique for patients with asthma living in the UAE and following inhaler training; secondly to investigate the effect of inhaler technique education using self-check pictorial labels on patients’ overall asthma control. Methods: This single-blinded randomized controlled study was conducted in 2019 and followed consecutive recruitment of asthma patients visiting respiratory clinics at Rashid Hospital in Dubai. Patients were using a controller inhaler (Turbuhaler (TH), Accuhaler (ACC), or pressurized metered-dose inhaler (pMDI)). Following recruitment, patients were randomized into active group receiving educational intervention plus the inhaler label, and control group receiving educational intervention without the label. Patients were assessed at baseline and at one-month on their inhaler technique and asthma control. Results: Participants (n = 245; 93 = TH, 70 = ACC, 82 = pMDI) showed a significant difference between the groups at one-month for inhaler technique scores for TH (active 5.29 ± 1.86 vs. control = 24.4 ± 21.28), ACC (active = 3.99 ± 1.43 vs. control = 25.45 ± 22.57), and pMDI (active = 4.59 ± 0.10 vs. control = 120.55 ± 17.2), p < 0.001 for all. Asthma control for active group indicated significant improvements compared to control for TH and pMDI (p < 0.001 for both), but not ACC group (p = 0.087). Conclusions: Retention of correct inhaler technique and improved asthma control can be enhanced by using a specialized inhaler technique label in image format.

scholarly journals A Review of Brooke Army Medical Center Chaplaincy Service During the SARS-COV2 Pandemic: Implications for Service Structure and Patient Needs

2021 ◽  
Author(s):  
Zaith Bauer ◽  
Joseph Sherwin ◽  
Stanley Smith ◽  
Jason Radowsky
Keyword(s):  
Mortality Rate ◽  
End Of Life ◽  
Medical Center ◽  
Well Being ◽  
Primary Study ◽  
P Value ◽  
Inpatient Setting ◽  
Spiritual Support ◽  
Army Medical ◽  
Brooke Army Medical

ABSTRACT Introduction We aimed to evaluate the effect of the SARS-COV2 pandemic on chaplain utilization at Brooke Army Medical Center. Our hypothesis was that multiple pandemic-related factors led to a care environment with increased mental and spiritual stress for patients and their families, leading to an increased need for adjunct services such as chaplaincy. Materials and Methods This was a single-institution retrospective chart review study that evaluated the records of 10,698 patients admitted between July 1, 2019, and January 31, 2020, or between July 1, 2020, and January 31, 2021. Our primary study outcomes included the number of chaplain consultations, the number of visits per consultation, and the time of visits between the two study cohorts. Secondary outcomes included inpatient mortality and the number of end-of-life visits. We also isolated a subgroup of patients admitted with COVID-19 and compared their outcomes with the two larger cohorts. Statistical analysis included t-test or chi-squared test, based on the variable. This study was reviewed and approved by the Brooke Army Medical Center Institutional Review Board (IRB ID C.2021.010e). Results Fewer consults were performed during the study period affected by the SARS-COV2 pandemic (4814 vs. 5884, P-value &lt;.01). There were fewer individual visits per consult during the study period affected by the SARS-COV2 pandemic (1.44 vs. 1.64, P-value &lt;.01), which led to fewer overall time spent per consult (37.41 vs. 41.19 minutes, P-value &lt;.01). The 2020 cohort (without COVID-19 cases) demonstrated a higher mortality rate than the 2019 cohort (2.8% vs. 1.9%, P-value &lt;.01). The COVID-19 diagnosis cohort demonstrated a much higher mortality rate compared to other patients in the 2020 cohort (19.3% vs. 2.8%, P-value &lt;.01). We demonstrated the relative need for EOL consults by presenting the ratio of EOL consults to inpatient deaths. This ratio was highest for the COVID-19 diagnosis cohort (0.76) compared to the 2020 cohort (0.50) and the 2019 cohort (0.60). Conclusions This study demonstrates that factors related to the SARS-COV2 pandemic resulted in fewer chaplaincy consults in our inpatient setting. We did not find other reports of a change in the rate of chaplaincy consultation, but available reports suggest that many centers have had difficulty balancing the spiritual needs of patients with local exposure guidelines. Although fewer individual chaplain consults occurred during the SARS-COV2 pandemic, our chaplain service innovated by utilizing various phone, video, and web-based platforms to deliver spiritual support to our community. Our study also suggests that the patients most greatly affected by the pandemic have an increased need for spiritual support, especially at the end of life. Future studies in this subject should examine the effect of various types of chaplain services as they relate to the health and well-being of hospitalized 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 Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma

Thorax ◽  
2018 ◽  
Vol 73 (11) ◽  
pp. 1041-1048 ◽  
Author(s):  
Andreas M Neophytou ◽  
Sam S Oh ◽  
Marquitta J White ◽  
Angel C Y Mak ◽  
Donglei Hu ◽  
...  
Keyword(s):  
African American ◽  
Asthma Control ◽  
Dose Response ◽  
Secondhand Smoke ◽  
Oral Steroid ◽  
Continuous Exposure ◽  
Asthma Exacerbations ◽  
Children With Asthma ◽  
Asthma Outcomes ◽  
American Children

BackgroundSecondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose–responses using biomarkers of exposure have not been widely reported.ObjectivesAssess dose–response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature.MethodsWe performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose–response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines.ResultsThe OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose–response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures.ConclusionsExposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose–response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.

Sign in / Sign up

Export Citation Format

Share Document