Ward based inhaler technique service reduces exacerbations of asthma and COPD.

Published on Oct 1, 2021in Respiratory Medicine3.415
· DOI :10.1016/J.RMED.2021.106583
Toby Capstick5
Estimated H-index: 5
(Leeds Teaching Hospitals NHS Trust),
Nooria F. Azeez (Leeds Teaching Hospitals NHS Trust)+ 3 AuthorsIan Clifton12
Estimated H-index: 12
(Leeds Teaching Hospitals NHS Trust)
Sources
Abstract
Abstract null null Background null The management of asthma and COPD is largely dependent on patients being able to use their inhaled medication correctly, but poor inhaler technique continues to be a recurring theme in studies and clinical practice. This is associated with poor disease control, increased risk of exacerbations and hospital admissions, and so there is a need to redesign services for patients to optimise their medicines use. null null null Methods null A novel ward-based dedicated inhaler technique service was developed, and pharmacy support workers trained to provide this, focusing on optimising inhaler technique using a checklist and recommending protocol-guided inhaler device switches. Inpatients on adult respiratory wards with a diagnosis of exacerbation of asthma or COPD consented to receive this service, and the impact on exacerbations and hospital admissions were compared in the 6-months before and after the intervention. null null null Results null 266 adults (74 asthma, 188 COPD, and four asthma-COPD overlap) received the inhaler technique service. Six-month exacerbation and hospital admission data were available for 184 subjects. Optimising inhaler technique achieved a significant reduction in the combined asthma and COPD annualised rate of moderate-to-severe exacerbations (Rate Ratio [RR] 0.75, p  null null null Conclusions null This novel inhaler technique service produced a significant reduction in the rate of moderate-to-severe exacerbations of asthma and COPD, and a reduction in the rate hospital admissions, length of stay and average cost of admission.
📖 Papers frequently viewed together
2019
20199.25Thorax
5 Authors (Tgd Capstick, ..., D Goddard)
2019
1 Author (E M Irusen)
References29
Newest
#1Marjan KerkhofH-Index: 75
#2Jaco VoorhamH-Index: 6
Last. David Price (Aberd.: University of Aberdeen)H-Index: 160
view all 10 authors...
Background Little is known about the impact of exacerbations on COPD progression or whether inhaled corticosteroid (ICS) use and blood eosinophil count (BEC) affect progression. We aimed to assess this in a prospective observational study. Methods The study population included patients with mild to moderate COPD, aged ≥35 years, with a smoking history, who were followed up for ≥3 years from first to last spirometry recording using two large UK electronic medical record databases: Clinical Practi...
Source
#1Xiaona Jia (PKU: Peking University)H-Index: 2
#2Shuang Zhou (PKU: Peking University)H-Index: 6
Last. Yimin Cui (PKU: Peking University)H-Index: 20
view all 6 authors...
OBJECTIVE: In patients with asthma and chronic obstructive pulmonary disease (COPD), disease control is still suboptimal-incorrect inhalation technique and medication non-adherence are two important reasons for this outcome. Pharmacists' interventions have been shown to have a positive effect on the clinical outcomes of asthma and COPD. Quantitative assessment of the efficacy of pharmacist-led interventions, mainly on inhalation techniques and medication adherence, is needed. Evidence for differ...
Source
#1O.S. Usmani (ICL: Imperial College London)H-Index: 34
Inhaled drug delivery is the cornerstone treatment for asthma and chronic obstructive pulmonary disease (COPD). However, use of inhaler devices can be challenging, potentially leading to critical errors in handling that can significantly reduce drug delivery to the lungs and effectiveness of treatment. A systematic review was conducted to define ‘critical’ errors and their impact on health outcomes and resource use between 2004 and 2016, using key search terms for inhaler errors in asthma and CO...
Source
#2Christina CallanH-Index: 2
Last. David Price (Aberd.: University of Aberdeen)H-Index: 160
view all 12 authors...
ABSTRACTObjective: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). Methods: We conducted a randomized, un-blinded, crossover study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient infor...
Source
#1David Price (Aberd.: University of Aberdeen)H-Index: 160
Last. Henry Chrystyn (PSU: Plymouth State University)H-Index: 30
view all 18 authors...
Background Poor inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. Objective The CRITical Inhaler mistaKes and Asthma controL study investigated the association between specific inhaler errors and asthma outcomes. Methods This analysis used data from the iHARP asthma review service—a multicenter cross-sectional study of adults with asthma. The review took place be...
Source
Abstract Introduction Understanding how pharmacy technicians and other pharmacy support workforce cadres assist pharmacists in the healthcare system will facilitate developing health systems with the ability to achieve universal health coverage as it is defined in different country contexts. The aim of this paper is to provide an overview of the present global variety in the technician and other pharmacy support workforce cadres considering; their scope, roles, supervision, education and legal f...
Source
#1Joaquín Sanchis (Autonomous University of Barcelona)H-Index: 34
#2Ignasi Gich (Autonomous University of Barcelona)H-Index: 40
Last. Søren Pedersen (University of Southern Denmark)H-Index: 57
view all 3 authors...
Background Problems with the use of inhalers by patients were noted shortly after the launch of the metered-dose inhaler (MDI) and persist today. We aimed to assess the most common errors in inhaler use over the past 40 years in patients treated with MDIs or dry powder inhalers (DPIs). Methods A systematic search for articles reporting direct observation of inhaler technique by trained personnel covered the period from 1975 to 2014. Outcomes were the nature and frequencies of the three most comm...
Source
#1Iman A. Basheti (Applied Science Private University)H-Index: 20
#2Sinthia Bosnic-Anticevich (WIMR: Woolcock Institute of Medical Research)H-Index: 52
Last. Helen K. Reddel (WIMR: Woolcock Institute of Medical Research)H-Index: 64
view all 4 authors...
Turbuhaler and Diskus are commonly used powder inhaler devices for patients with respiratory disease. Their effectiveness is limited in part by a patient's ability to use them correctly. This has led to numerous studies being conducted over the last decade to assess the correct use of these devices by patients and health care professionals. These studies have generally used device-specific checklists to assess technique, this being the most feasible and accessible method for assessment. However,...
Source
#1Eline Tommelein (UGent: Ghent University)H-Index: 8
#2Els Mehuys (UGent: Ghent University)H-Index: 24
Last. Guy Brusselle (EUR: Erasmus University Rotterdam)H-Index: 93
view all 10 authors...
AIM: Few well-designed randomized controlled trials (RCT) regarding the impact of community pharmacist interventions on pharmacotherapeutic monitoring of patients with Chronic Obstructive Pulmonary Disease (COPD) have been conducted. We assessed the effectiveness of a pharmaceutical care program for patients with COPD. METHODS: The PHARMACOP-trial is a single-blind 3-month RCT, conducted in 170 community pharmacies in Belgium, enrolling patients prescribed daily COPD medication, aged ≥50 years, ...
Source
#1Sawsan Baddar (Sultan Qaboos University)H-Index: 4
#2B Jayakrishnan (Sultan Qaboos University)H-Index: 9
Last. Omar A Al-Rawas (Sultan Qaboos University)H-Index: 11
view all 3 authors...
AbstractObjectives: The available assessment tools to determine asthma control do not include components assessing factors that may directly affect control. Our aim was to evaluate the relationship between patient compliance, inhaler technique and the level of asthma control. Methods: Scores from the Asthma Control Test, individual inhaler device checklists and a novel questionnaire on the patient’s medication regimen were used to measure control, inhaler technique and compliance, respectively, ...
Source
Cited By0
Newest
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.