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Opportunistic optimization of inhaler technique in hospitalized adults with asthma: a two-phase educational study
Kouranloo, Koushan Dey, Mrinalini Hanna, Joseph Singh, Ananya Rafferty, Alice Scott, Stephen
Kouranloo, Koushan
Dey, Mrinalini
Hanna, Joseph
Singh, Ananya
Rafferty, Alice
Scott, Stephen
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EPub Date
Publication Date
2023-03-21
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Article - VoR
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Abstract
To investigate effectiveness of two different educational methods to improve inhaler techniques in patients with prior diagnosis of asthma, hospitalized with a non-asthma-related diagnosis.
Methods
We undertook a real-world, opportunistic quality-improvement project. Inhaler technique in hospitalized patients with prior diagnosis of asthma was assessed in two cohorts over two 12-week cycles using a standardized device-specific proforma of seven-step inhaler technique, classed: “good” if 6/7 steps achieved; “fair” if 5/7 compliant; “poor” for others. Baseline data was collected in both cycles. Cycle one involved face-to-face education by a healthcare professional; cycle two involved additional use of an electronic device to show device-specific videos (asthma.org.uk). In both cycles, patients were reassessed within two days for improvements and the two methods compared for effectiveness.
Results
During cycle one 32/40 patients were reassessed within 48 h; eight lost to follow-up. During cycle two 38/40 patients were reassessed within 48 h; two lost to follow-up During cycle one, two and 12 had good/fair baseline technique respectively, and 26 poor. Most commonly missed steps were no expiry check/not rinsing mouth after steroid use. On reassessment 17% patients improved from poor to fair/good. During cycle two, initial technique assessment identified: 23 poor; 12 fair; five good. Post-videos, 35% of patients improved from poor to fair/good. Proportion of patients improving from poor to fair, or poor/fair to good increased in cycle two vs one (52.5% vs 33%).
Conclusion
Visual instruction is associated with improved technique compared to verbal feedback. This is a user-friendly and cost-effective approach to patient education.
Citation
Kouranloo, K., Dey, M., Hanna, J., Singh, A., Rafferty, A., & Scott, S. (2023). Opportunistic optimization of inhaler technique in hospitalized adults with asthma: a two-phase educational study. Journal of Asthma, 60(9), 1775-1786. https://doi.org/10.1080/02770903.2023.2187304
Publisher
Taylor & Francis
Journal
Journal of Asthma
Research Unit
DOI
10.1080/02770903.2023.2187304
PubMed ID
PubMed Central ID
Type
Article
Language
Description
Series/Report no.
ISSN
0277-0903
EISSN
1532-4303