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Pharmacists' training to improve inhaler technique of patients with COPD in Vietnam

Authors Nguyen TS, Nguyen TLH, Pham TTV, Hua S, Ngo QC, Li SC

Received 26 January 2018

Accepted for publication 27 March 2018

Published 11 June 2018 Volume 2018:13 Pages 1863—1872

DOI https://doi.org/10.2147/COPD.S163826

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Tu-Son Nguyen,1,2 Thi Lien Huong Nguyen,1 Thi Thuy Van Pham,1 Susan Hua,2 Quy Chau Ngo,3 Shu Chuen Li2

1Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam; 2School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; 3Respiratory Centre, Bach Mai Hospital, Hanoi, Vietnam

Background: Incorrect use of inhalers is very common and subsequently leads to poor control of COPD. Among health care providers, pharmacists are in the best position to educate patients about the correct use of inhaler devices.
Objective: The objective of this study was to evaluate the impact of pharmacist-led training on the improvement of inhaler technique for COPD patients in Vietnam.
Patients and methods: For this pre- and post-intervention study, standardized checklists of correct use of metered-dose inhalers (MDIs) and dry powder inhalers (DPIs) were used to evaluate the inhaler technique. A scoring system (maximum score =8) was applied before and after training to guarantee assessment uniformity among pharmacists. Three methods including “face-to-face training”, “teach-back” and “technique reminder label” were used. After the baseline evaluation (T0), the inhaler technique was reassessed after 1 month (T1), 3 months (T2), 6 months (T3) and 12 months (T4).
Results: A total of 211 COPD patients participated in the study. Before the training, a high rate of errors was recorded. After the training, the percentage of patients using MDIs and DPIs perfectly increased significantly (p<0.05). The mean technique score for MDIs and DPIs improved from 6.0 (T0) to 7.5 (T3) and 6.9 (T4) and 6.7 (T0) to 7.6 (T3) and 7.2 (T4), respectively (p<0.05). The average training time was 6 minutes (T0) and 3 minutes (T3), respectively.
Conclusion: Pharmacist-led comprehensive inhaler technique intervention program using an unbiased and simple scoring system can significantly improve the inhaler techniques in COPD patients. Our results indicated a 3-month period as the optimal time period between training and retraining for maintaining the correct inhaler technique. The training would be highly feasible and suitable for implementing in the clinical setting. Our model of pharmacist-led training should be considered as an effective solution for managing COPD patients and better utilization of health care human resources, especially in a developing country like Vietnam.

Keywords: MDI, Turbuhaler®, teaching and scoring methods, technique score, technique reminder label

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