Effects of instructional materials on the proper techniques of inhaler device use

Respir Investig. 2022 Sep;60(5):633-639. doi: 10.1016/j.resinv.2022.04.010. Epub 2022 Jun 2.

Abstract

Background: Inhaled medication is the cornerstone of pharmacological treatment for asthma. Poor inhaler techniques are associated with poor asthma control and an increased risk of exacerbations. Leaflets and videos are provided by several pharmaceutical companies to explain the proper techniques to patients. We investigated the effects of instructional materials (leaflet and video) on the patient's inhaler techniques.

Methods: The subjects were 67 medical students at Kagoshima University. They all were provided with two types of inhalation devices: a dry powder inhaler (DPI) and a pressurized metered-dose inhaler (pMDI). The students were assigned to three groups: (1) leaflet, (2) video, and (3) combination (leaflet + video). Pulmonologists observed and assessed the students' use of the devices by using a validated checklist. The percentage of subjects who avoided critical errors was also assessed. Critical errors were errors that affected drug delivery to the lungs substantially.

Results: The percentage of overall competence and the number of steps that were mastered out of the 11 steps were higher in the combination group than those in the other two groups. However, only 40% in the combination group were able to successfully execute every critical step. The percentage of subjects who avoided critical errors was also higher in the combination group than in the other groups.

Conclusions: A single form of instructional materials (leaflet or video) was insufficient for acquiring proper inhaler techniques. The combination of two learning materials may help patients with asthma acquire proper inhaler techniques and subsequently, improve their asthma control.

Keywords: Asthma; Critical error; Inhaler technique; Leaflet; Video.

MeSH terms

  • Administration, Inhalation
  • Asthma* / drug therapy
  • Dry Powder Inhalers
  • Humans
  • Lung
  • Metered Dose Inhalers*