Opportunistic optimization of inhaler technique in hospitalized adults with asthma: A two-phase educational study.

Kouranloo, Koushan ORCID: 0000-0002-6276-137X, Dey, Mrinalini ORCID: 0000-0001-6858-4338, Hanna, Joseph, Singh, Ananya, Rafferty, Alice and Scott, Stephen (2023) Opportunistic optimization of inhaler technique in hospitalized adults with asthma: A two-phase educational study. The Journal of asthma : official journal of the Association for the Care of Asthma, 60 (9). pp. 1-17.

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Official URL: http://dx.doi.org/10.1080/02770903.2023.2187304

Abstract

ObjectiveTo investigate effectiveness of two different educational methods to improve inhaler techniques in patients with prior diagnosis of asthma, hospitalized with a non-asthma-related diagnosis.MethodsWe undertook a real-world, opportunistic quality-improvement project. Inhaler technique in hospitalized patients with prior diagnosis of asthma was assessed in two cohorts over two 12-week cycles using a standardized device-specific proforma of seven-step inhaler technique, classed: "good" if 6/7 steps achieved; "fair" if 5/7 compliant; "poor" for others. Baseline data was collected in both cycles. Cycle one involved face-to-face education by a healthcare professional; cycle two involved additional use of an electronic device to show device-specific videos (asthma.org.uk). In both cycles, patients were reassessed within two days for improvements and the two methods compared for effectiveness.ResultsDuring cycle one 32/40 patients were reassessed within 48hours; eight lost to follow-up. During cycle two 38/40 patients were reassessed within 48hours; two lost to follow-upDuring cycle one, two and 12 had good/fair baseline technique respectively, and 26 poor. Most commonly missed steps were no expiry check/not rinsing mouth after steroid use. On reassessment 17% patients improved from poor to fair/good.During cycle two, initial technique assessment identified: 23 poor; 12 fair; five good. Post-videos, 35% of patients improved from poor to fair/good.Proportion of patients improving from poor to fair, or poor/fair to good increased in cycle two vs one (52.5% vs 33%).ConclusionVisual instruction is associated with improved technique compared to verbal feedback. This is a user-friendly and cost-effective approach to patient education.

Item Type:	Article
Uncontrolled Keywords:	Asthma, inhaler technique, patient education, quality improvement
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	16 Mar 2023 08:44
Last Modified:	27 Jul 2023 12:27
DOI:	10.1080/02770903.2023.2187304
Open Access URL:	https://www.tandfonline.com/doi/full/10.1080/02770...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3169111