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Clinical Trial
. 2020 Nov 12;10(1):19676.
doi: 10.1038/s41598-020-76961-y.

The effects of repeated inhaler device handling education in COPD patients: a prospective cohort study

June Hong Ahn  1 , Jin Hong Chung  2 , Kyeong-Cheol Shin  2 , Hyun Jung Jin  2 , Jong Geol Jang  2 , Mi Suk Lee  2 , Kwan Ho Lee  3
Affiliations
Clinical Trial

The effects of repeated inhaler device handling education in COPD patients: a prospective cohort study

June Hong Ahn et al. Sci Rep. .

Abstract

Inhaler education for chronic obstructive pulmonary disease (COPD) patients improves inhaler technique and adherence. However, the effects of such education on the quality of life and inhaler satisfaction remain unclear. Here, we evaluated inhaler handling and adherence, and changes in quality of life and inhaler satisfaction, after repeated education for COPD patients. We prospectively enrolled COPD patients who had used inhalers for over 1 month and evaluated the effects of repeated education. Three visits were made over 6 months; an advanced practice nurse evaluated inhaler technique and adherence, and instructed the patients in inhaler technique during face-to-face sessions. Inhaler technique and adherence were assessed at every visits, and the modified Medical Research Council (mMRC) test, COPD Assessment Test (CAT), EuroQol-5D (EQ-5D), Patient Health Questionnaire (PHQ-9), and Feeling of Satisfaction with Inhaler questionnaire (FSI-10) were administered before (visit 1) and after two educational sessions (visit 3). A total of 261 COPD patients (308 inhalers) were included. Education significantly reduced the proportion of critical errors after two educational sessions (visit 3), from 43.2 to 8.8% (p < 0.001). The proportion of highly compliant patients increased after two visits, from 81.6% to 87.7% (p = 0.005). The FSI-10 score improved significantly after education, from 44.36 ± 4.69 to 47.64 ± 4.08 (p < 0.001); the scores on the other instruments (mMRC, CAT, EQ-5D, and PHQ-9) did not improve. Repeated face-to-face inhaler education by an advanced practice nurse significantly improved inhaler satisfaction, technique, and adherence. However, inhaler education did not significantly improve quality of life.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the study subjects. COPD chronic obstructive pulmonary disease, DPI dry powder inhaler, pMDI pressurized metered-dose inhaler, SMI soft mist inhaler.
Figure 2
Figure 2
Inhaler use critical errors before and after education.
Figure 3
Figure 3
Adherence before and after education.
See this image and copyright information in PMC

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