Practice on Meter Dose Inhaler Techniques and Its Associated Factors Among Asthmatic Patients at Debre Markos Comprehensive Specialized Hospital, East Gojjam, Ethiopia: A Prospective Study.

Background: Asthma is ranked 16th among the leading causes of years lived with disability and 28th among the leading causes of disease in the world. Metered dose inhaler remains the principal route for drug administration and it has greater advantages over systemic treatment. In routine use, however, a vast majority of patients make inhalation errors. Suboptimal inhaler technique worsens health outcomes, with poor disease control, and increases the risk of hospitalization. This study aimed to assess practice metered-dose inhalation techniques and associated factors among asthmatic patients at Debre Markos comprehensive specialized hospital, East Gojjam, Amhara region, Ethiopia. Methods: Prospective cross-sectional study was conducted from July 15 to August 30/ 2020. Data were collected through a semi-structured questioner. The data was analyzed using SPSS version 25. Associations between dependent and independent variables were assessed by using binary and multiple logistic regressions. P-values less than 0.05 were considered to be statistically significant in all cases. Results presented in tables, figures, numbers, and percentages. Result: A total of 166 patients had involved in the study, of which 52.4% were females. One hundred eleven (66.9%) of participants had good knowledge of asthma and inhalational techniques with the rest of them had poor knowledge. One hundred eight (65.1%) patients had effective practice on metered-dose inhaler use techniques. Participant's knowledge regarding asthma and meter dose inhaler and marital status has a significant association with their practice of metered-dose inhaler techniques with P-value 0.001 and 0.006 respectively. Conclusion: In this study, most participants are suffering from asthma for a long duration and they have repeated exacerbation. Around two-thirds of patients had good knowledge regarding asthma and meter dose inhaler and practice on metered-dose inhaler techniques. Participants who had poor knowledge and who were unmarried had poor practice on tech metered-dose inhaler techniques. Health education and counseling services should be consistently provided to the clients regarding the proper steps of inhalers use.

Critical Inhaler Administration Errors of Patients on Pressurized Meter Dose Inhaler (pMDI): A Hospital-Based Cross-Sectional Study in Malaysia

Background: Inhaler technique errors can affect the disease outcome through reduced deposition of medication in the lungs with certain errors were more likely to deter the optimum drug from reaching the lung. The objective of this study was to evaluate the pressurized metered-dose inhaler (pMDI) critical technique errors among asthma and COPD patients, and to investigate the predictors of those errors. Methods: A cross-sectional, observational, and multi-centered study conducted in 3 major hospitals in the state of Penang, Malaysia. Asthma and COPD patients aged 18 years or older consented to the study were consecutively recruited if they were at least on 1 pMDI without mouthpiece spacer or facemask space. Direct observation of the patient’s technique was recorded using a standard checklist and certain steps in the checklist were pre-determined as critical steps. The number of patients missed or incorrectly performed the steps including the critical steps were documented. Using logistic regression, the factors associated with the critical errors were determined, and the correlation was evaluated between age and pMDI knowledge score with critical inhalation steps score. Results: Of 209 patients observed, only less than half (40.7%) could perform all the critical pMDI steps correctly. Low education level was the only factor associated with critical inhaler errors. The increased knowledge of their inhaled medication was found to positively correlate with the correct critical inhalation steps. The critical errors also increase with the increased age of patients. Conclusion: The majority of the study population make inhalation error particularly in critical steps. Training and education intervention programs may help patients with lower education level, as well as those of advanced age and lack of knowledge of their inhaled medication because those populations are at a greater risk of committing critical errors in their use of pMDI.

Stability Matrix Designs: A Boon For Stability Testing of Pharmaceutical Drug Products.

Long term stability is done in a matrix approach after manufacturing of drug for ensuring the stability of drugs. Using the matrix basic design which is useful for testing 3 lots under one storage condition can be expanded to multiple presentation of products or multiple storage conditions. The design shows full testing at the end points (0 and 36 months) and shows partial testing at the interim time points (3, 6, 9, 12, 18 &24 min). With the assistance of a statistical search algorithm, the test points are selected . 37.5% reduction in analytical testing, while permitting a reliable interim expiry estimate. Based on 12 months stability data it is provided by the proposed matrix design. The matrix approach obtained by expiration dating periods is typically more conservative than the approaches derived from the full testing estimate. The comparison of expiration dating estimate for meter dose inhaler and capsules is presented using the matrixed and full testing approaches.

Prevalence of breathing difficulty and evaluating the use of inhaler among public in rural area

Asthma and COPD are common diseases of the airways and lungs that have a major impact on the health of the population. Major limitation to the effective use of inhaled medications is the inability of many patients to use various inhaler devices correctly. Patients require appropriate education in the correct handling of inhaled medications. Objective of the study is the prevalence of breathing difficulty and evaluating the use of inhaler among public in rural area. Methodology includes a cross sectional questionnaire study carried out among 35 people in rural area. The study is mainly based on the use of inhaler techniques among peoples leave in a particular locality and taken there duration of disease, medications, frequency of using the inhaler to determine the correct way of using the inhaler. Result includes about 35 patients were responded. Among them 36.5% were female patients and 23.5% were males. Most of the patients have asthma 24%. most often people have correct knowledge about inhaler use. 59.3% people using meter dose inhaler and 37% people use rotahaler. about 63% people use inhaler whenever necessary, 25.9% people use inhaler twice a day, 3.7% use after a long journey and 7.4% use all of the above. The opportunity for technological innovation and educational interventions to reduce errors is highlighted, as well as the specific challenges faced by children.

Automation of an Atomized Meter Dose Inhaler for Lung Disease Patients

A reliable universal triggering system for atomized meter doseinhalers was built. Although the exact dosage into the airway system at different triggering delays was not possible to be determined by means of directly measuring its weight, the use of lasers reflection and high speed movie is an effective comparison method to determine the appropriate triggering moment. A set of transparent tubes was built to imitate the dimensions of a human trachea and bronchiole and two lasers were placed coaxially with such tubes. Light from the lasers was only reflected when the atomized medicine was passing through the tubes;so the longer the time the laser light could be seen, the more effective amount of dosage was being delivered to the lungs. From the experiment, it seems that the best delay time for triggering an inhaler is in the range between 0.7-1.s under the flow rate specified. Any time before that will result in medicine loss, and any time after that the patient might not be able to keep inhaling.