Category: Federal Forum Posters
Purpose: Asthma, one of the most common non-communicable diseases, is characterized by bronchial hyper-responsive and inflammatory hyperactive airway disorder. Asthma disease is hindered by trigger factors as environmental exposures and inappropriate utilization of the devices. Ensuring effective and appropriate use of the inhalers in asthmatic patients is a cornerstone in the therapeutic treatment and optimizing treatment outcomes. The purpose of this study was to evaluate the practice of the use of the various types of inhalers as metered dose inhaler (MDI), dry powder inhaler (DPI), turbuhaler, and accuhaler among asthmatic patients.
Methods: This is a prospective multicenter study conducted on patients from schools, community pharmacies, and physician clinics across different Lebanese geographic areas from February till May 2019. Patients diagnosed with asthma and are self-dependent to effectively use the inhaler devices by themselves are enrolled in the study. Patients with psychiatric or mental disorders are excluded from the study. Eligible patients are interviewed by trained pharmacists through face-face contact to assess the practice of the inhaler use and a point is given to each correct step providing a total score to classify the study subjects as “poor”, “intermediate” or “good” inhaler users. The study is approved by the institutional review board and written informed consent obtained from each enrolled participant. Data analysis is performed using statistical package for social sciences (SPSS) version 21.0.
Results: A total number of 172 asthmatic patients are enrolled in the study with a mean age of 31.79 ± 20.92 years and 55.8% are females. The majority of the patients 89 (51.7%) use MDI, 14 (8.1%) MDI plus spacer, 31 (18.0%) turbuhaler, 32 (18.6%) accuhaler users and 6 (3.5%) DPI. Around 36% of the MDI and 3.1% of the accuhaler patients are classified as “bad users”. And about 19.1% of the MDI and 66.7% of the DPI patients are classified as “good users”. Concerning MDI, the commonly encountered errors are 63.4% for not shaking the device before use and 62.4% for not holding the breath for 5 to 10 seconds after use. As for MDI with spacer, around 50% don’t exhale before nor hold the breath for 5 to 10 seconds after use. For the turbuhaler, accuhaler, and DPI mainly not holding the breath for 5 to 10 seconds is the most commonly reported pitfall among the patients.
Conclusion: Patient education program should be implemented to incorporate patient’s awareness about avoidance of asthma triggers and ensure adequate education tailored for the appropriate use of devices according to the inhaler type. The findings show that patients aren’t fully oriented about the accurate steps to follow when using the inhalers. The results highlight the need for pharmacist counseling and follow-up to ensure patient education and optimize therapeutic outcome.