Use Of Metered-dose Inhalers Research Articles

The effect of mode of inhaled salbutamol delivery on measures of small airways obstruction in asthma: a comparison of treatment delivered via spacer and nebuliser

Background Conventional clinical respiratory tests tell us little about the small airways of the lung (less than 2 mm in internal diameter). Patients with asthma affecting the small airways may respond differently to inhaled bronchodilator treatment (salbutamol) depending on the method of administration. Aims In this study, we aimed to assess if there was a difference in the effect of salbutamol treatment via metered-dose inhaler (MDI) and spacer compared to via nebuliser on measures of small airways function. It was hypothesised that the nebulised salbutamol would have a greater effect on the outcome measures due to the particle size being more appropriate for penetrating the smaller airways. Methods Two visits were completed by 14 participants with stable asthma. At both visits, lung function tests were completed both before and after administration of 1 mg salbutamol to measure airway obstruction (spirometry), mechanical load to ventilation (impulse oscillometry), and ventilation heterogeneity (multiple breath nitrogen washout). At visit one, seven participants were randomized to take salbutamol via MDI and spacer, and seven via nebuliser. At visit two, all participants took salbutamol via whichever method they had not been given at visit one. Results Results indicated that participants given salbutamol via MDI and spacer (compared to via nebuliser) showed a greater improvement, which was statistically significant, between the pre- and post-salbutamol values for most lung function tests. Discussion This result was unexpected and may have been due to greater wastage of drug via nebuliser than via MDI and spacer, and differing inhalation patterns. Tidal breathing during nebulised administration, and deep inhalation during use of MDI and spacer, could have affected the delivery of the drug. Conclusion This study implies that taking salbutamol via MDI and spacer would be beneficial if higher doses (e.g. 1 mg) were taken.

Compliance & Practices Related to Inhalation Therapy (MDI/DPI) Among Asthma Patients

Background Asthma is respiratory disease characterized by acute episode of spasm of bronchi in lungs leading to difficulty in breathing.Most often it is related to theallergic reaction of airways. It is treated with inhalation therapy that is metered dose inhaler (MDI) and dry powder inhaler (DPI).However, the desired treatment outcomes are not observed due to ineffective compliance and practices of MDI /DPI (metered dose inhaler and dry powder inhalers) Aims and objectives Assess the compliance related to MDI/DPI therapy among asthma patients Evaluate the practices related to MDI/DPI therapy among asthma patients. Design It was exploratory observational study patients were contacted in the outpatient department and their interview was conducted thereafter their practices related to the use of MDI/DPI were assessed. Methods: The study included 50 asthma patients undergoing mdi/dpi therapy at GMCH 32 Chandigarh. The data was collected by through interview method for compliance and practices related to inhalation therapy (MDI/DPI) were assessed through checklist among asthma patients Results: Compliance score showed that 72% of subjects had good compliance (7-9) with good MDI use, practices 82% (11-15).correlation between compliance and practices was calculated with spearman correlation method and it was found to be positive correlation (0.54). Co-relation between compliance and practices were calculated by using the rank difference. It showed that there was positive co- relation between compliance and practices. Association between compliance and socio-demographic variables (age, monthly income, affected compliance) Similarly, between practices and socio-demographic variables association (marital statusand monthly income) was found to be significant. Conclusion: Desired medical outcomes are possible with adequate health education and compliance of patients to the medical regimen as well as the appropriate practices related to the MDI/DPI. As observed during the study the education part of the patient is dependent on the nursing personnel who is demonstrating and taking feedback of the patients about the compliance as well as the difficulties faced by them, while using the MDI/DPI. Hence, the study reveals the integral part that is health education is an essential part for desired patient outcome. Keywords : practice, compliance, nursing, practice base learning

Brief Education Improves Proper Metered-Dose Inhaler Use.

Inhaled β-agonists are the cornerstone of acute treatment for asthma and chronic lung disease. Upon emergency department (ED) discharge, patients optimally receive prescriptions for metered-dose inhalers (MDIs) with instructions on their proper use. Yet prior studies suggest that ED personnel have limited knowledge of proper MDI techniques. It is unclear how effectively brief education will improve this knowledge to enable them to provide adequate patient instructions. Our aim was to evaluate ED medical personnel's baseline knowledge of MDI use and the utility of brief education on their ability to use MDIs. After providing written consent, a spirometry nurse evaluated emergency physicians and nurses on their ability to properly perform three (open-mouth/two-finger, spacer, and closed-mouth) MDI techniques. The same spirometry nurse then gave a short educational session demonstrating the proper MDI techniques. Two weeks later, the nurse re-evaluated the same personnel on their MDI techniques. All emergency medical personnel initially performed poorly in demonstrating proper MDI technique, averaging 29.8% steps done correctly. Two weeks after their educational session, they improved greatly, averaging 89.4% steps done correctly. This study demonstrated both that ED personnel had poor initial knowledge about MDI techniques and that a brief educational intervention improved most people's ability to use, and presumably to instruct patients/parents in proper use of, MDIs.

Barriers to and competency with the use of metered dose inhaler and its impact on disease control among adult asthmatic patients in Ethiopia

BackgroundAsthma is one of the chronic diseases which affects the airway, and inhalers are the preferred medications to treat this problem. Improper inhalational technique leads to decreased efficacy of the medication by reducing its deposition in the lungs. The aim of this study was to assess the barriers to and competency with the use of Metered Dose Inhaler (MDI) and its impact on disease control among adult asthmatic patients.MethodsA prospective cross-sectional study was conducted in University of Gondar comprehensive specialized hospital outpatient department (OPD) chronic follow up from 12-March-2018 to 15-May- 2018. Patients were interviewed face to face with questions which determined their competency, asthma control level and barriers for inhaler use.ResultOverall, 307 asthmatic patients were included in the study. More than half of participants were females, 170 (55.4%) and lived in urban area 185 (60.3%). The mean age of the respondents was 51.77 years with a standard deviation of ±15.40. The cost of medication, 282 (91.9%) and the perception that medication should be used in response to symptoms but not on a regular basis 277 (90.2%) were the most identified barriers. Only 56 (18.2%) were competent for Metered Dose Inhaler use (MDIU) and 17 (5.5%) patients had well controlled asthma. Being not competent AOR 0.168[0.41–0.687] was one of the factors decreasing asthma control.ConclusionGenerally from this study, cost of the medication and the perception that medication should be used only for symptoms were the major identified barriers that affect the MDI use among asthmatic patients. Patients show very poor competence to their MDI which in turn led to poor asthma control. So, patients need to be taught the correct inhaler technique in the hospital and pharmacy while they came for follow up every time.

The use of nebulized pharmacotherapies during the COVID-19 pandemic.

Coronavirus disease 2019 (COVID-19), caused by the highly contagious novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a worldwide pandemic and currently represents a major public health issue. COVID-19 has highlighted the need for clear and accurate guidance on the use of aerosol-generating procedures, such as nebulization, for the treatment of patients with respiratory diseases with or without COVID-19. Despite the lack of evidence, there is heightened concern about the potential risk of transmission of SARS-CoV-2 in the form of aerosolized respiratory droplets during the nebulized treatment of patients with COVID-19. Consequently, the use of metered-dose inhalers (MDIs) has risen considerably as an alternative to nebulized therapy, which has led to inadequate supplies of MDIs in some parts of the United States. In this article, we review and discuss the role of nebulization in patients with SARS-CoV-2 and the treatment of noninfected patients with chronic respiratory diseases. The following two important questions are addressed: (1) should nebulized therapy be used in hospital or home settings by patients infected with SARS-CoV-2; and (2) should nebulized therapy be continued in patients already using it for chronic respiratory disease management in hospital or home settings? The reviews of this paper are available via the supplemental material section.

Evaluation of the knowledge and correct use of metered-dose inhalers by healthcare professionals and medical students in Gauteng Province.

Background The Global Initiative for Asthma (GINA) estimates that South Africa (SA) has over 3.9 million asthma sufferers, of whom 1.5% die of the condition annually. SA has the world’s fourth highest asthma death rate among 5 - 35-year-olds. Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death globally by 2030, and will surpass HIV/AIDS in Africa. Uncontrolled asthma and COPD are frequent causes of emergency department visits and hospital admissions. Poor metered-dose inhaler (MDI) technique is probably a major contributory cause. It is the responsibility of all treating doctors and healthcare professionals to educate patients on inhaled therapy with the correct MDI technique, as well as to routinely check and repeatedly demonstrate the technique to them. Objectives This study evaluated study participants’ knowledge of MDI technique, and their compliance in checking and demonstrating MDI use to patients prescribed inhaled therapy. The study participants included doctors, nurses and final-year medical students at Helen Joseph Hospital and Chris Hani Baragwanath Academic Hospital, in the Departments of Internal Medicine and Emergency Medicine, and the Division of Pulmonology. Methods A total of 195 study participants volunteered to take part in the study. A questionnaire was administered to participants to gauge their perceptions, level of knowledge and understanding of MDI technique. They were then requested to demonstrate correct inhaler technique via a placebo MDI. Participants’ use of a placebo MDI was evaluated by a scoring system. Results The total sample of 195 comprised 130 (67%) female and 65 (33%) male participants. Of these, 133 (68%) were qualified medical staff, and 62 were final-year medical students. Only 32 (16%) could demonstrate correct MDI technique. Over 50% of participants did not demonstrate MDI technique to patients, or check their patients’ technique at every hospital-related visit. Conclusion Healthcare professionals and final-year medical students have poor knowledge of inhaler technique and are ill-prepared to teach patients. Also of concern is that the majority do not routinely demonstrate or observe patients’ inhaler technique.

Evaluation of the knowledge and correct use of metered-dose inhalers by healthcare professionals and medical students in Gauteng Province

Background. The Global Initiative for Asthma (GINA) estimates that South Africa (SA) has over 3.9 million asthma sufferers, of whom 1.5% die of the condition annually. SA has the world’s fourth highest asthma death rate among 5 - 35-year-olds. Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death globally by 2030, and will surpass HIV/AIDS in Africa. Uncontrolled asthma and COPD are frequent causes of emergency department visits and hospital admissions. Poor metered-dose inhaler (MDI) technique is probably a major contributory cause. It is the responsibility of all treating doctors and healthcare professionals to educate patients on inhaled therapy with the correct MDI technique, as well as to routinely check and repeatedly demonstrate the technique to them. Objectives. This study evaluated study participants’ knowledge of MDI technique, and their compliance in checking and demonstrating MDI use to patients prescribed inhaled therapy. The study participants included doctors, nurses and final-year medical students at Helen Joseph Hospital and Chris Hani Baragwanath Academic Hospital, in the Departments of Internal Medicine and Emergency Medicine, and the Division of Pulmonology. Methods. A total of 195 study participants volunteered to take part in the study. A questionnaire was administered to participants to gauge their perceptions, level of knowledge and understanding of MDI technique. They were then requested to demonstrate correct inhaler technique via a placebo MDI. Participants’ use of a placebo MDI was evaluated by a scoring system. Results. The total sample of 195 comprised 130 (67%) female and 65 (33%) male participants. Of these, 133 (68%) were qualified medical staff, and 62 were final-year medical students. Only 32 (16%) could demonstrate correct MDI technique. Over 50% of participants did not demonstrate MDI technique to patients, or check their patients’ technique at every hospital-related visit. Conclusion. Healthcare professionals and final-year medical students have poor knowledge of inhaler technique and are ill-prepared to teach patients. Also of concern is that the majority do not routinely demonstrate or observe patients’ inhaler technique.

Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study.

Asthma is a heterogeneous disease which is characterized by chronic airway inflammation. It is a common chronic respiratory disease affecting 1–18% of population in different countries. It can be treated mainly with inhaled medications in several forms, including pressurized metered-dose inhaler (MDI). Patients encountered difficulty in using inhaler devices even after repeated demonstration and/re-evaluation. This could highly compromise patient treatment outcome/asthma control. To evaluate relationship between MDI use technique and asthma control among adult asthmatic patients who attend respiratory clinic in Jimma University Medical Center (JUMC), Southwest Ethiopia. A prospective observational study was conducted from March to August 22, 2018. All adult asthmatic patients who met the inclusion criteria were included in the study. Patient baseline assessment was conducted (patient demography, inhalation technique, adherence, and asthma control status). Inhalation technique was obtained using a standard checklist of steps recommended in National Institute of Health (NIH) guidelines. Patient adherence using asthma inhalation test and asthma control status was assessed by 2017 GINA guideline. Independent predictors of outcome were identified, strength of association between dependent and independent variables was determined by using ordinal logistic regression analysis, and statistical significance was considered at P < 0.05. One hundred forty patients were included in the analysis. Among these, 26 (18.4%) patients were controlled, 65 (46.1%) partially controlled, and 35% uncontrolled. Proportion of patients with uncontrolled asthma were higher among inefficient as compared to efficient, whereas patients with controlled asthma were higher among efficient as compared to inefficient. Asthma control status is significantly associated with inhalation technique (P=0.006). Since most of the patients were inefficient and it is significantly associated with asthma control status, the hospital tried to adopt video MDI teaching program, and the patient should ask healthcare professionals how to take medication and they should bring their device to receive demonstration during visit. Health professionals should re-evaluate the patient during their hospital visit and encourage bringing their device to give demonstration.

Which Method is More Effective in Aerochamber Training in Pediatric Age Group?

Objective: Spacer and metered-dose inhaler use is widespread especially among pediatric population. In children, training in medication use is provided both for the family and the child. The aim of the present study was to investigate whether this training is well comprehended and which training method is more effective to achieve that goal. Methods: This study included patients presenting to our outpatient clinic who were in need of spacer and metered-dose inhaler use. The study subjects had an age range of 2-16 years. The patients were randomized into two groups. The first group was trained on metered-dose inhaler use by video demonstration. The second group was trained by applied verbal training. They asked to use spacer and metered-dose inhaler, and they were rated from 0 to 6, as in previous studies. Errors and deficiencies of use were re-explained. They were informed about their scores and were told that they would be rated again in the next follow-up appointment. They were asked again to use spacer and metered-dose inhaler and rated between 0 and 6 at the second-month control visit. Results: The intra-group analysis of the video group showed a significant difference between the first-month and second-month total scores (p<0,01). The intra-group analysis of the verbal training group also showed a significant difference between the first-month and second-month total scores (p<0,01). Conclusion: In conclusion, we demonstrated the positive effect of actively inclusion of patients with asthma into the training about spacer and metered-dose inhaler use. We ensured active participation by exam motivation. Here in we aimed to contribute to the existing literature.

Inhalation Technique Errors with Metered-Dose Inhalers Among Patients with Obstructive Lung Diseases: A Systematic Review and Meta-Analysis of U.S. Studies.

Metered dose inhalers (MDIs) are commonly prescribed for inhalation therapy, but correct use is critical to promoting effective medication delivery. This systematic literature review and meta-analysis evaluates the overall and step-by-step prevalence of errors among adults with obstructive lung diseases in the United States who used MDIs. Electronic and manual searches conducted between 1979-2018 using PubMed, EMBASE, PsycINFO, Cochrane, and Google identified 10 articles that met the following inclusion criteria: (a) English language, (b) U.S. adults diagnosed with chronic obstructive pulmonary disease, and (c) MDI use error rates. Meta-analytic techniques using random-effects models were applied to calculate effect sizes, weighted proportions, and 95% confidence intervals (CIs). Heterogeneity was assessed by the I2 statistic. Aggregate findings revealed that 86.7% of patients (n=390, 95% CI 77.5-96.0) made at least 1 inhalation technique error, and 76.9% (n=885, 95% CI 65.8-87.9) incorrectly performed ≥ 20% of device use steps. The most prevalent step-by-step errors across the studies (n=1105) were failure to: (a) exhale fully and away from the inhaler before inhalation (65.5% [95% CI 52.0, 78.9]); (b) hold breath for 5-10 seconds (41.9% [95% CI 29.8, 53.9]); (c) inhale slowly and deeply (39.4% [95% CI 26.2, 52.5]); (d) exhale after inhalation (35.9% [95% CI 17.0, 54.8]); and (e) shake the inhaler before use (34.2% [95% CI 30.6, 37.7]). Across the studies used in this meta-analysis more than three-fourths of U.S. adults with obstructive lung diseases used MDIs incorrectly. Our findings suggest the need for ongoing patient education and consideration of alternative devices to mitigate errors.

Clinical burden of asynchrony in patients with asthma when using metered-dose inhalers for control.

Background: Asynchrony, or lack of coordination between inhalation and actuation when using a pressurized metered-dose inhaler (MDI), could theoretically impact the delivery of inhaled medications and treatment efficacy. Objective: To assess the real-world association between asynchrony and clinical outcomes among patients with asthma who receive controller therapy delivered by MDIs. Methods: A cohort of patients was assembled via electronic health records. The patients were aged ≥12 years, with one or more documentations of an asthma diagnosis, no diagnosis of chronic obstructive pulmonary disease, and two or more prescriptions for an inhalation aerosol corticosteroid alone or with long-acting beta-2-agonist delivered via MDI. Their inhaler technique, demonstrated by using a placebo MDI, was evaluated at a clinic visit by study nurses who used a standardized 10-step checklist. Asynchrony was defined as any gap in timing between inhalation and actuation. Clinical outcomes were assessed via electronic health records during the 6 months before the clinic visit and were compared between patients with and patients without asynchrony by using multivariable regression analyses adjusted for age, gender, asthma severity proxy, and baseline comorbidities. Results: Of the total 254 eligible patients, mean age of 49.3 years, 90 males (35.4%), 32 (12.6%) had asynchrony. Patients with asynchrony had higher odds of an asthma exacerbation (adjusted odds ratio, 2.99; p = 0.009), and lower odds of risk domain asthma control (adjusted odds ratio, 0.41; p = 0.04) compared with patients without asynchrony. Conclusion: This study provided real-world evidence that asynchrony in MDI use among patients with asthma who were treated with controller MDIs was associated with clinical burden in terms of asthma exacerbations and control.

FREQUENCY OF IMPROPER INHALER TECHNIQUE IDENTIFIED BY ELECTRONIC MEDICATION MONITOR (EMM) ACTUATION TIMING

Introduction Inadequate inhalation technique from metered dose inhalers (MDIs) is common. Up to 90% of patients with asthma use techniques that may negatively impact MDI efficacy. Based on guidelines and patient information leaflets >30 seconds are needed between two inhalations to achieve proper MDI use that includes shaking the canister, exhaling completely before inhalation, inhaling slowly, and breath-holding after use. This study aimed to detect inadequate inhalation technique by quantifying the time between two consecutive actuations using EMMs that passively collected time and date of use. Methods Data were collected from patients ≥4 years old with asthma who were using EMM-equipped rescue and/or controller MDIs (2012-18). In patient-days with two actuations within 120 seconds(s), the interval between the first two actuations was quantified and then classified as acceptable (>30s), fair (15 to ≤30s), or poor (≤15s) based on guideline criteria. This study was exempted from IRB approval. Results Of the 7,558 patients, 6,616 used rescue MDIs on 120,882 days, and 3,220 used controller MDIs on 157,492 days. The median (interquartile range) interval between actuations was 9s (16s), and 16%, 17%, and 67% of actuations were classified as acceptable, fair and poor, respectively (Figure 1). Results were similar between rescue and controller MDIs. Conclusions This study demonstrates that most patients have inadequate intervals between MDI actuations. EMMs can be useful to detect inadequate inhalation technique by examining the interval between actuations as a determinant. This information can be used to inform patients and providers that inhalation technique education is needed to improve treatment. Figure 1. Seconds between 1st and 2nd actuation, n = 278,374 patient-days from 7,558 patients.

Improving efficiency of pediatric emergency asthma treatment by using metered dose inhaler

Objective: Evidence suggests using metered dose inhaler (MDI) to treat acute asthma in the Emergency Department reduces length of stay, though methods of implementation are lacking. We modified a treatment pathway to recommend use of MDI for mild-moderate asthma in a pediatric ED. Methods: A baseline review assessed discharged patients >2 years with an asthma diagnosis and non-emergent Emergency Severity Index triage assessment (3/4). Our multi-disciplinary team developed an intervention to increase MDI use instead of continuous albuterol (CA) using the following: (1) Redesign the asthma pathway and order set recommending MDI for ESI 3/4 patients. (2) Adding a conditional order for Respiratory Therapists to reassess and repeat MDI until patient reached mild assessment. The primary outcome was the percentage discharged within 3 hours, with a goal of a 10% increase compared to pre-intervention. Balancing measures included admission and revisit rates. Results: 7635 patients met eligibility before pathway change; 12,673 were seen in the subsequent 18 months. For target patients, the percentage discharged in <3 hours increased from 39% to 49%; reduction in median length of stay was 33 minutes. We identified special cause variation for reduction in CA use from 43% to 25%; Revisit rate and length of stay for higher-acuity patients did not change; overall asthma admissions decreased by 8%. Changes were sustained for 18 months. Conclusion: A change to an ED asthma pathway recommending MDI for mild-moderate asthma led to a rapid and sustained decrease in continuous albuterol use, length of stay, and admission rate.

A Report of an Asthma Pathway Leading to Improved Resource Use.

Asthma pathways have been shown to improve resource use and decrease length of stay (LOS). A tertiary care hospital implemented an asthma pathway in May 2015 to standardize inpatient care. We predicted that the pathway would increase the use of albuterol metered-dose inhalers (MDIs) and steroids; decrease use of albuterol nebulizer, antibiotics, chest radiograph (CXR), and respiratory viral panel (RVP); and decrease LOS. This retrospective cohort study selected patients between the ages of 2 and 18 years who were admitted for asthma as a primary diagnosis between May 2014 and May 2016 (1 year preimplementation to 1 year postimplementation). Patients' complex chronic conditions were excluded. We analyzed use of albuterol nebulizer, MDI, and continuous nebulization, ipratropium bromide, oral steroids, antibiotics, inhaled steroids, CXR, and RVP. We also evaluated LOS and readmission rate. There were 1131 and 925 patients identified before and after asthma pathway implementation, respectively. The percent that received albuterol nebulizer decreased from 14.1% to 6.1% (p < 0.001). The percent that received albuterol MDI increased from 97.0% to 99.4% (p < 0.001). The average number of MDI administrations decreased from 11.6 to 10.4 (p = 0.004). Continuous albuterol use increased from 52.3% to 59.1% (p = 0.002). There was no change in ipratropium bromide, oral steroid, inhaled steroid, or CXR use. Antibiotic (p = 0.049) and RVP (p = 0.03) use decreased. The average LOS decreased from 1.84 days to 1.71 days (p = 0.02). Readmission rates did not change significantly. The asthma pathway improved inpatient albuterol MDI use. The LOS decreased while maintaining readmission rates.

Pharmacists' training to improve inhaler technique of patients with COPD in Vietnam.

BackgroundIncorrect use of inhalers is very common and subsequently leads to poor control of COPD. Among health care providers, pharmacists are in the best position to educate patients about the correct use of inhaler devices.ObjectiveThe objective of this study was to evaluate the impact of pharmacist-led training on the improvement of inhaler technique for COPD patients in Vietnam.Patients and methodsFor this pre- and post-intervention study, standardized checklists of correct use of metered-dose inhalers (MDIs) and dry powder inhalers (DPIs) were used to evaluate the inhaler technique. A scoring system (maximum score =8) was applied before and after training to guarantee assessment uniformity among pharmacists. Three methods including “face-to-face training”, “teach-back” and “technique reminder label” were used. After the baseline evaluation (T0), the inhaler technique was reassessed after 1 month (T1), 3 months (T2), 6 months (T3) and 12 months (T4).ResultsA total of 211 COPD patients participated in the study. Before the training, a high rate of errors was recorded. After the training, the percentage of patients using MDIs and DPIs perfectly increased significantly (p<0.05). The mean technique score for MDIs and DPIs improved from 6.0 (T0) to 7.5 (T3) and 6.9 (T4) and 6.7 (T0) to 7.6 (T3) and 7.2 (T4), respectively (p<0.05). The average training time was 6 minutes (T0) and 3 minutes (T3), respectively.ConclusionPharmacist-led comprehensive inhaler technique intervention program using an unbiased and simple scoring system can significantly improve the inhaler techniques in COPD patients. Our results indicated a 3-month period as the optimal time period between training and retraining for maintaining the correct inhaler technique. The training would be highly feasible and suitable for implementing in the clinical setting. Our model of pharmacist-led training should be considered as an effective solution for managing COPD patients and better utilization of health care human resources, especially in a developing country like Vietnam.

KARAKTERISTIK INFORMASI TERKAIT CARA PENGGUNAAN METERED-DOSE INHALER DENGAN SPACER YANG MENGANDUNG KOMBINASI BETA-2 AGONIS DAN KORTIKOSTEROID OLEH APOTEKER DI APOTEK WILAYAH SURABAYA TIMUR

ABSTRACT&#x0D; Treatment of respiratory disorders using a metered-dose inhaler (MDI) with spacer becomes one of the important points. Pharmacists at pharmacies are the final key in therapy to ascertain how the use of inhalation tools is correct. This study aims to determine the completeness of each step of information on how to use MDI with spacer given by pharmacists at pharmacies in East Surabaya. The research design used is cross-sectional study with the subject of research is pharmacist in pharmacy. The research variable is the explanation of how to use MDI inhaler with spacer. An assessment method of 8 steps on how to use MDI with spacer and each number gets a value. Research subjects were 22 pharmacists. Most pharmacists describe each step orally by using the tool directly, ie at step: 1a (77.27%), 1b (77.27%), 2 (81.81%), 3 (31.81%) , 4a (59.09%), 4b (13.63%), 5a (100%), 5b (63.63%), 6a (90.90%), 6b (40.90%), 8a (9 , 09%), and 8b (9.09%). Most of the pharmacists explain verbally with a demonstration tool but only one pharmacist can explain all the steps completely. Therefore, pharmacists need to improve IEC services related to the use of MDI with a spacer for respiratory treatment.&#x0D; &#x0D; Keywords : information on how to use inhaler, Metered-Dose Inhaler (MDI), spacer, pharmacist, pharmacy

Must-Do Instruction for Metered-Dose Inhalers: Provider Perspectives

Background: Proper metered-dose inhaler (MDI) use is essential for effective management of asthma symptoms, but reports show that many patients do not use them effectively. The National Heart, Lung, and Blood Institute recommends that healthcare providers educate and assess patients’ MDI technique at each opportunity. Our site had performed a pilot study that showed mean correct 7-step MDI use by parents on admission, after in-hospital training, and at 2 weeks post discharge of 5.7 (SD 1.6), 7 (SD 0), and 4.8 (SD 1.3), suggesting need for continued training outside the hospital. Limited …

ASSESSMENT OF KNOWLEDGE OF APPROPRIATE USE OF METERED DOSE INHALER AND DRY POWDER INHALER AMONG PHARMACY STUDENTS USING SIMULATED PATIENT APPROACH: A CLINICAL PHARMACIST‐LED INTERVENTION

RespirologyVolume 22, Issue S3 p. 96-96 APSR Poster Abstracts ASSESSMENT OF KNOWLEDGE OF APPROPRIATE USE OF METERED DOSE INHALER AND DRY POWDER INHALER AMONG PHARMACY STUDENTS USING SIMULATED PATIENT APPROACH: A CLINICAL PHARMACIST-LED INTERVENTION First published: 24 November 2017 https://doi.org/10.1111/resp.13207_26Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume22, IssueS3Supplement: 22nd Congress of the Asian Pacific Society of Respirology, International Convention Centre, Sydney, Australia, 23–26 November 2017November 2017Pages 96-96 RelatedInformation

STUDI KELENGKAPAN PENJELASAN INFORMASI CARA PENGGUNAAN CONTROLLERMETERED-DOSE INHALER (MDI) YANG MENGANDUNG KORTIKOSTEROID SEBAGAI TERAPI ASMA DI APOTEK KABUPATEN TUBAN

This experiment centred in metered dose inhaler (MDI) device which used routinely by asthma patient as controller therapy. MDI used ask patient’s skill more when using their medication. MDI technique informnation provided by pharmachist are important to achive optimal medication in asthma therapy. By a non experimental study, mysterious patient collect MDI technique gived by pharmacist in Tuban pharmacy using observacional and cross sectional method. Information about MDI technique comprehensive collected by two ratter as mysterious patient which assessed with checklist that got measseured by kappa to know ratter aggrement percentage. The result showed from a total sampling under 41 pharmachist which represent each 41 pharmacy in Tuban, by purposive sampling Pharmacists as pharmaceutical personnel responsible for information services at pharmacies, including information on how to use MDI. Most of the apothecary's ability level in providing information is still lacking, then continued with adequate technique, and optimal technique in providing complete information of MDI use for asthma patient. Pharmacists know how to use MDI and no pharmacist is unexpected or not familiar with MDI as an asthma therapy. Pharmacists in Tuban district have a tendency to inform only four stages of the nine stages of MDI use from Osman et al (2012), ie at the 1st, 3rd, 5th, and 6th stages of MDI use

Breathe easy: 5 steps to better breathing with your metered-dose inhaler (MDI)

Proper use of the metered-dose inhaler (MDI) is essential for medications to prevent and treat acute asthma exacerbations. This training video teaches children and clinicians correct technique for MDI use.