[Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease]

Abstract

Objective: To predict the effect of a brief educational intervention aimed at improving the inhaler technique on the reduction of exacerbations in patients with COPD over a year.

Matherial and methods: A triple blind, randomised controlled clinical trial with parallel design.

Inclusion criteria: to be between 40-75 years, having been diagnosed with COPD, and being on treatment with inhalers. A total of 97 patients were randomly selected. They were randomly assigned into 2groups according to their functional severity measured with spirometry. Intervention group: evaluation of the inhalation technique. Their mistakes were corrected using a brief educational intervention. Reinforcement visits were made in the second and seventh month.

Control group: evaluation of the inhalation technique. No educational intervention was made. After 1 year of follow-up, the number of exacerbations in each group was checked.

Variables measured: social and demographic, study, dyspnoea level, body-mass index, tobacco use, FEV₁, FEV₁/FVC, COPD stage, BODEX index, number, type, and inhaler technique, number of previous exacerbations. Bayesian inference analysis was performed using logistic regression models.

Results: A total of 56 patients were assigned to de intervention group and 41 to the control one. There were 16 and 14 lost to follow-up, respectively. In the intervention group, 44.6% of the patients had an exacerbation, compared to the control group, with 56.1%. OR adjusted = 0.57 (95% CI: 0.22-1.22). Posterior probability OR < 1 = 93%. Exacerbations which required hospital admission had an OR = 0.21 (95% CI: 0.02-0.75) with posterior probability OR < 1= 99%.

Conclusions: A brief educational technique is an effective method for reducing the number of exacerbations in patients with COPD.

Keywords: Análisis bayesiano; Bayesian analysis; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Exacerbación; Exacerbation; Inhaladores; Inhalators.