Effectiveness of Various Methods of Teaching Proper Inhaler Technique

Abstract

Objective: To compare the effectiveness of 4 different instructional interventions in training proper inhaler technique.

Design: Randomized, noncrossover trial.

Setting: Health fair and indigent clinic.

Participants: Inhaler-naive adult volunteers who spoke and read English.

Interventions: Subjects were assigned to complete the following: (1) read a metered dose inhaler (MDI) package insert pamphlet, (2) watch a Centers for Disease Control and Prevention (CDC) video demonstrating MDI technique, (3) watch a YouTube video demonstrating MDI technique, or (4) receive direct instruction of MDI technique from a pharmacist.

Primary outcome: Inhaler use competency (completion of all 7 prespecified critical steps).

Results: Of the 72 subjects, 21 (29.2%) demonstrated competent inhaler technique. A statistically significant difference between pharmacist direct instruction and the remaining interventions, both combined ( P < .0001) and individually ( P ≤ .03), was evident. No statistically significant difference was detected among the remaining 3 intervention groups. Critical steps most frequently omitted or improperly performed were exhaling before inhalation and holding of breath after inhalation.

Conclusion: A 2-minute pharmacist counseling session is more effective than other interventions in successfully educating patients on proper inhaler technique. Pharmacists can play a pivotal role in reducing the implications of improper inhaler use.

Keywords: COPD; asthma; inhaler technique; patient education; pharmacist counseling.