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)
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.
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