Inhaler technique errors in Romanian patients with asthma – a multicenter study
Received 22 March 2019
Accepted for publication 7 July 2019
Published 19 August 2019 Volume 2019:13 Pages 1401—1414
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Laura Adela Munteanu,1 Ariadna Petronela Fildan,2 Emanuela Tudorache,1 Ovidiu Fira-Mladinescu,1 Mirela Frandes,3 Bogdan Timar,3 Cristian Oancea,1 Doina Ecaterina Tofolean2
1Department of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Faculty of Medicine, Internal Medicine Discipline, Medical Clinical Disciplines I, “Ovidius” University of Constanta, Constanta, Romania; 3Department of Biostatistics and Medical Informatics, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
Correspondence: Ariadna Petronela Fildan
Faculty of Medicine, Internal Medicine Discipline, Medical Clinical Disciplines I, “Ovidius” University of Constanta. Aleea Universitatii nr.1, Constanta 900470, Romania
Tel +40 74 115 7526
Background: Non-adherence to treatment is associated with poor asthma control, increased exacerbations, decline in lung function, and decreased quality of life. M-health applications have become increasingly in the last years, but little research regarding the efficiency of the instructional videos for correct inhaler use exist. The aim of this study is to assess and improve the inhalator technique and to establish which types of errors were made more often with the help of a mobile health application.
Materials and methods: Seventy-five patients with partially controlled or uncontrolled asthma, using any of turbuhaler, diskus, pressurized metered dose inhaler (pMDI) or soft mist inhaler (SMI), were included in the study. When they first entered the study, the patient’s inhaler technique was assessed by a trained medical professional and the technique errors were categorized in handling, respectively inhalation errors. After the first evaluation, the patients downloaded an application on their Smartphone and were encouraged to use the application as much as needed to remind them the correct inhalation technique. The patients were re-called every three months for evaluation, treatment, and assessment of inhalation technique.
Results: We analyzed both handling and inhalation errors for each of the four considered inhalers. We observed a significantly reduced number of inhalation technique errors after using the mobile phone application. Turbuhaler median errors were 6.00, and after six months we did not observe errors. Diskus median error was 6.00, and after six months we observed a maximum of one error. pMDI median errors were 7.00, and after six months we observed just one error. Similarly, SMI median error was 7.00, and after six months we observed just one error.
Conclusion: Although technique inhalation errors are very common among asthma patients, video instructions provided through specific mobile phone applications could improve the inhaler technique in order to achieve a better control of the disease.
Keywords: inhaler device, mobile phone application, adherence
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