Assessment of key influences on asthma inhaler device selection in trained asthma practice nurses

Abstract

The impact of asthma is felt throughout the UK with an average primary care organisation treating 45,000 people for asthma with 439 emergency hospital admissions and eight deaths due to asthma each year (National Asthma Campaign 2001). Optimal asthma management is reliant on individualised patient focused selection of appropriate treatment via a suitable inhaler device. To identify the most important influences on asthma inhaler device selection in a group of asthma trained nurses. Interviews and a focus group were conducted in order to gain information that could be used to develop a questionnaire on which to base a pilot study. Interviews, focus group and pilot study were all held in a semi-rural area of England. Subjects: 3 NRTC asthma nurse experts, eight local asthma trained practice nurses and a non random sample of 18 asthma trained nurses. Practice nurse's identified influences such as patient age, cost to the practice and patient preference as being the most important influences with experts also highlighting the importance of evidence from research and adherence to current national asthma guidelines. The subsequent pilot study showed that ease of use and patient's manual dexterity had the greatest influence on a nurse's choice of device, with adherence to national asthma guidelines and training in asthma management in third and fourth places. Inhaler devices need to be easy to use by the majority of patients to ensure optimal asthma management, while national asthma guidelines also play a prominent role in device selection. Asthma education should include this information in order to promote optimal symptom control.