Introduction : Drug administration using a metered dose inhaler (MDI) device
has become the mainstay of therapy in respiratory disorders, such as asthma
and chronic obstructive pulmonary disease . Correct inhalation technique is
critical in ensuring optimal drug delivery to the airways, and thereby its
efficacy. However, erroneous inhalation technique is very common in patients
with chronic airflow obstruction and hence, appropriate training is essential
for all these patients to ensure optimal therapy. We attempted to analyze the
technique of patients using manually operated MDIs, and again re analyzed
after a structured educational intervention,
Methods: This Analytical study had a randomised, parallel-group design .
Subjects were randomly selected from patients with respiratory disorders, aged
20 years and above, and Prior Consent from the patients were taken & was
found to be within ethical standards. It was conducted among patients
admitted to or attending to various local secondary health centres & tertiary
medical care institutes selected randomly. Patients who did not self-administer
their MDI or had linguistic difficulty in understanding the instructions were
excluded from the study. A time period of Four months was chosen as the
point of re-evaluation for inhaler technique.
Results: A significant difference was observed in the median score
improvement achieved in the practical demonstration group compared with
the written instruction group (p<0.001). The median score achieved by the
entire group was 3 (range, 1-8), which increased to 6, 7 and 8, respectively in
the subsequent interventions. At the completion of three sessions of
intervention, 98% of subjects were able to achieve a full score. Of these, 25%
patients achieved a full score after the first intervention itself while 36% and
39 % patients reached the full score after 2 and 3 interventions, respectively.
Conclusion: There is a high prevalence of faulty usage of inhaler technique
among patients. Repeated demonstration of the proper technique using a
standard check-list significantly reduces the errors committed during inhaler
use.
Key Word : MDI , Inhaler , COPD , NIH Guideline
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