Kouranloo, KoushanDey, MrinaliniHanna, JosephSingh, AnanyaRafferty, AliceScott, Stephen2023-07-222023-07-222023-03-21Kouranloo, 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/10.1080/02770903.2023.21873040277-090310.1080/02770903.2023.2187304http://hdl.handle.net/10034/627931To 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.Licence for VoR version of this article starting on 2023-03-21: http://creativecommons.org/licenses/by/4.0/https://creativecommons.org/licenses/by/4.0/Pulmonary and Respiratory MedicineImmunology and AllergyPediatrics, Perinatology and Child HealthArticle1532-4303Journal of Asthma2023-07-22