Inhalation technique assessment and evaluation for the need of pharmaceutical intervention in respiratory pathologies patients.

Abstract

OBJECTIVE\nTo evaluate rate and type of errors in inhalation technique\xa0of patients seen in hospitals at the observation area in the\xa0 emergency\xa0department, as well as patients seen in the outpatients clinic\xa0 at the\xa0primary care pharmaceutical consultation, and at the\xa0 community pharmacy.\n\n\nMETHOD\nDescriptive observational study carried out by a hospital\xa0 pharmacist,\xa0along with a primary care pharmacist and a community\xa0 pharmacist.\xa0An anonymous survey was performed in order to collect\xa0 different\xa0analyzed data. Each patient was asked to execute a complete\xa0 demonstration\xa0on how they used their inhalers, to actively check the\xa0 inhalation\xa0technique. Two checklists regarding the type of inhaler were\xa0 established\xa0in order to assess said technique. Results were tabulated\xa0 through Microsoft\xa0Excel® 2010 software and analyzed through R 3.5\xa0 statistical program.\n\n\nRESULTS\nA total of 66 patients (42 male, 24 female; mean age 67)\xa0were\xa0 recruited. Out of all patients, 48.5% used more than one\xa0 inhaler,\xa0which 34.4% used different types of inhaler, and 65.6% used\xa0 different\xa0systems. A total of 39 patients were under dry powder inhaler\xa0 therapy,\xa0and 38 were using pressurized metered dose inhalers. The\xa0 most frequent\xa0errors -both in dry powder inhalers and pressurized\xa0 metered dose inhalers-were: not performing a 10 second apnea and not\xa0 slowly expelling\xa0air from the lungs. Around 50% of patients needed\xa0 new learning after\xa0assessing their inhalation technique, even though\xa0 88.5% had already received previous training. Older aged patients\xa0 performed a worse inhalation technique.\n\n\nCONCLUSIONS\nThere is a high rate of errors in the use of inhaled\xa0 therapy,\xa0being even higher among older aged patients. The inhalation\xa0 technique\xa0training by the medical staff seems inadequate, as it is crucial\xa0 to raise\xa0awareness about the importance of health education for\xa0 patients and their\xa0use of inhalers, to which a scheduled follow up and a\xa0 technical and\xa0feedback obtained from the patient assessment is\xa0 required.