Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique

Andrea S Melani, Marco Bonavia, Eliuccia Mastropasqua, Alessandro Zanforlin, Marco Lodi, Paola Martucci, Nicola Scichilone, Maria Aliani, Margherita Neri, Piersante Sestini, Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO)

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices.

METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 adult subjects (mean ± SD age 64 ± 15 y) experienced with inhaler use, mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics. These subjects received face-to-face practical education from trained caregivers until proper inhaler use could be demonstrated, and the time of instruction was recorded.

RESULTS: The mean times (95% CIs) in minutes of instruction required for rectifying misuse and demonstrating inhaler mastery were 5.0 (3.6-6.4) min for the Diskus (n = 199), 5.3 (3.7-6.8) min for the HandiHaler (n = 219), 8.1 (5.6-10.5) min for the metered-dose inhaler (MDI) (n = 532), and 6.0 (5.0-7.0) min for the Turbuhaler (n = 169). The time to demonstrate good inhaler use for MDIs was higher (P < .05) than for all dry powder inhalers (DPIs). Between the DPIs, only the HandiHaler required more time for achieving mastery than the Diskus (P = .005). The variables associated with increasing time for correcting inhaler errors were an older age (0.05 min/y, 95% CI 0.03-0.07), a lower level of education (0.4 min/schooling level, 95% CI 0.7-0.1), and no reported previous instruction in inhaler use (1.96 min, 95% CI 1.35-2.58).

CONCLUSIONS: In experienced subjects with baseline faulty inhaler use, the mean time of education required to achieve and demonstrate mastery with DPIs was lower than with MDIs.

Original languageEnglish
Pages (from-to)409-414
Number of pages6
JournalRespiratory Care
Volume62
Issue number4
DOIs
Publication statusPublished - Apr 2017

Fingerprint

Nebulizers and Vaporizers
Dry Powder Inhalers
Education
Metered Dose Inhalers
Caregivers
Equipment and Supplies
Chronic Obstructive Pulmonary Disease
Thorax
Asthma
Cross-Sectional Studies

Keywords

  • Journal Article

Cite this

Melani, A. S., Bonavia, M., Mastropasqua, E., Zanforlin, A., Lodi, M., Martucci, P., ... Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO) (2017). Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique. Respiratory Care, 62(4), 409-414. https://doi.org/10.4187/respcare.05117

Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique. / Melani, Andrea S; Bonavia, Marco; Mastropasqua, Eliuccia; Zanforlin, Alessandro; Lodi, Marco; Martucci, Paola; Scichilone, Nicola; Aliani, Maria; Neri, Margherita; Sestini, Piersante; Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO).

In: Respiratory Care, Vol. 62, No. 4, 04.2017, p. 409-414.

Research output: Contribution to journalArticle

Melani, AS, Bonavia, M, Mastropasqua, E, Zanforlin, A, Lodi, M, Martucci, P, Scichilone, N, Aliani, M, Neri, M, Sestini, P & Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO) 2017, 'Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique', Respiratory Care, vol. 62, no. 4, pp. 409-414. https://doi.org/10.4187/respcare.05117
Melani AS, Bonavia M, Mastropasqua E, Zanforlin A, Lodi M, Martucci P et al. Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique. Respiratory Care. 2017 Apr;62(4):409-414. https://doi.org/10.4187/respcare.05117
Melani, Andrea S ; Bonavia, Marco ; Mastropasqua, Eliuccia ; Zanforlin, Alessandro ; Lodi, Marco ; Martucci, Paola ; Scichilone, Nicola ; Aliani, Maria ; Neri, Margherita ; Sestini, Piersante ; Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO). / Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique. In: Respiratory Care. 2017 ; Vol. 62, No. 4. pp. 409-414.
@article{a9210176a6cc4006b3d570345d59f0be,
title = "Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique",
abstract = "BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices.METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 adult subjects (mean ± SD age 64 ± 15 y) experienced with inhaler use, mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics. These subjects received face-to-face practical education from trained caregivers until proper inhaler use could be demonstrated, and the time of instruction was recorded.RESULTS: The mean times (95{\%} CIs) in minutes of instruction required for rectifying misuse and demonstrating inhaler mastery were 5.0 (3.6-6.4) min for the Diskus (n = 199), 5.3 (3.7-6.8) min for the HandiHaler (n = 219), 8.1 (5.6-10.5) min for the metered-dose inhaler (MDI) (n = 532), and 6.0 (5.0-7.0) min for the Turbuhaler (n = 169). The time to demonstrate good inhaler use for MDIs was higher (P < .05) than for all dry powder inhalers (DPIs). Between the DPIs, only the HandiHaler required more time for achieving mastery than the Diskus (P = .005). The variables associated with increasing time for correcting inhaler errors were an older age (0.05 min/y, 95{\%} CI 0.03-0.07), a lower level of education (0.4 min/schooling level, 95{\%} CI 0.7-0.1), and no reported previous instruction in inhaler use (1.96 min, 95{\%} CI 1.35-2.58).CONCLUSIONS: In experienced subjects with baseline faulty inhaler use, the mean time of education required to achieve and demonstrate mastery with DPIs was lower than with MDIs.",
keywords = "Journal Article",
author = "Melani, {Andrea S} and Marco Bonavia and Eliuccia Mastropasqua and Alessandro Zanforlin and Marco Lodi and Paola Martucci and Nicola Scichilone and Maria Aliani and Margherita Neri and Piersante Sestini and {Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO)}",
note = "Copyright {\circledC} 2017 by Daedalus Enterprises.",
year = "2017",
month = "4",
doi = "10.4187/respcare.05117",
language = "English",
volume = "62",
pages = "409--414",
journal = "Respiratory Care",
issn = "0020-1324",
publisher = "by Daedalus Enterprises",
number = "4",

}

TY - JOUR

T1 - Time Required to Rectify Inhaler Errors Among Experienced Subjects With Faulty Technique

AU - Melani, Andrea S

AU - Bonavia, Marco

AU - Mastropasqua, Eliuccia

AU - Zanforlin, Alessandro

AU - Lodi, Marco

AU - Martucci, Paola

AU - Scichilone, Nicola

AU - Aliani, Maria

AU - Neri, Margherita

AU - Sestini, Piersante

AU - Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri (AIPO)

N1 - Copyright © 2017 by Daedalus Enterprises.

PY - 2017/4

Y1 - 2017/4

N2 - BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices.METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 adult subjects (mean ± SD age 64 ± 15 y) experienced with inhaler use, mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics. These subjects received face-to-face practical education from trained caregivers until proper inhaler use could be demonstrated, and the time of instruction was recorded.RESULTS: The mean times (95% CIs) in minutes of instruction required for rectifying misuse and demonstrating inhaler mastery were 5.0 (3.6-6.4) min for the Diskus (n = 199), 5.3 (3.7-6.8) min for the HandiHaler (n = 219), 8.1 (5.6-10.5) min for the metered-dose inhaler (MDI) (n = 532), and 6.0 (5.0-7.0) min for the Turbuhaler (n = 169). The time to demonstrate good inhaler use for MDIs was higher (P < .05) than for all dry powder inhalers (DPIs). Between the DPIs, only the HandiHaler required more time for achieving mastery than the Diskus (P = .005). The variables associated with increasing time for correcting inhaler errors were an older age (0.05 min/y, 95% CI 0.03-0.07), a lower level of education (0.4 min/schooling level, 95% CI 0.7-0.1), and no reported previous instruction in inhaler use (1.96 min, 95% CI 1.35-2.58).CONCLUSIONS: In experienced subjects with baseline faulty inhaler use, the mean time of education required to achieve and demonstrate mastery with DPIs was lower than with MDIs.

AB - BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices.METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 adult subjects (mean ± SD age 64 ± 15 y) experienced with inhaler use, mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics. These subjects received face-to-face practical education from trained caregivers until proper inhaler use could be demonstrated, and the time of instruction was recorded.RESULTS: The mean times (95% CIs) in minutes of instruction required for rectifying misuse and demonstrating inhaler mastery were 5.0 (3.6-6.4) min for the Diskus (n = 199), 5.3 (3.7-6.8) min for the HandiHaler (n = 219), 8.1 (5.6-10.5) min for the metered-dose inhaler (MDI) (n = 532), and 6.0 (5.0-7.0) min for the Turbuhaler (n = 169). The time to demonstrate good inhaler use for MDIs was higher (P < .05) than for all dry powder inhalers (DPIs). Between the DPIs, only the HandiHaler required more time for achieving mastery than the Diskus (P = .005). The variables associated with increasing time for correcting inhaler errors were an older age (0.05 min/y, 95% CI 0.03-0.07), a lower level of education (0.4 min/schooling level, 95% CI 0.7-0.1), and no reported previous instruction in inhaler use (1.96 min, 95% CI 1.35-2.58).CONCLUSIONS: In experienced subjects with baseline faulty inhaler use, the mean time of education required to achieve and demonstrate mastery with DPIs was lower than with MDIs.

KW - Journal Article

U2 - 10.4187/respcare.05117

DO - 10.4187/respcare.05117

M3 - Article

C2 - 27999149

VL - 62

SP - 409

EP - 414

JO - Respiratory Care

JF - Respiratory Care

SN - 0020-1324

IS - 4

ER -