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

June Hong Ahn,Kwan Ho Lee,Kyeong-Cheol Shin,Jong Geol Jang,Jin Hong Chung,Mi Suk Lee,Hyun Jung Jin

doi:10.1038/s41598-020-76961-y

June Hong Ahn, Kwan Ho Lee + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-76961-y

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Journal: Scientific Reports	Publication Date: Nov 12, 2020
Citations: 17	License type: open-access

Affiliation: Yeungnam University Medical Center

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.

Highlights

Chronic obstructive pulmonary disease (COPD) exhibits many different phenotypes, and the prevalence ranged from 12.9 to 17.2% in the Korean National Health and Nutritional Examination Survey II (KNHANES II)[1,2]
Few studies have examined the association between inhaler education and quality of life[6,13,14,15]; no study has explored the relationship between inhaler education and inhaler satisfaction
We found that repeated education significantly improved satisfaction in chronic obstructive pulmonary disease (COPD) patients

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) exhibits many different phenotypes, and the prevalence ranged from 12.9 to 17.2% in the Korean National Health and Nutritional Examination Survey II (KNHANES II)[1,2]. In the real world, inhaler mishandling and poor adherence are very common, despite the fact that most COPD patients receive education on inhaler u se[3,5,6]. Many studies have shown that education reduces inhaler mishandling, significantly improving inhaler technique[6,7,8,9]. Quality of life of COPD patients was lower than that of the general population. High severity of COPD, depression, and osteoporosis were associated with lower quality of life in Korean COPD patients[11]. Multinational, cross-sectional, real-world survey with COPD patients, significant association was reported between inhaler satisfaction and treatment adherence. We evaluated inhaler handling and adherence, and changes in quality of life and inhaler satisfaction, after repeated education for COPD patients

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Conclusion