Exploring General Practitioners' Preferences and Experience with Respiratory Inhaler Devices

Biljana Cvetkovski; Charlotte Hespe; Rachel House; Vicky Kritikos; Elizabeth Azzi; Jack Evans; Pamela Srour-Alphonse; Sinthia Bosnic-Anticevich

doi:10.1007/s41030-022-00197-6

Exploring General Practitioners' Preferences and Experience with Respiratory Inhaler Devices

Pulm Ther. 2022 Sep;8(3):283-296. doi: 10.1007/s41030-022-00197-6. Epub 2022 Jul 30.

Authors

Biljana Cvetkovski¹, Charlotte Hespe², Rachel House¹, Vicky Kritikos¹, Elizabeth Azzi^{1

3

4}, Jack Evans^{1

5}, Pamela Srour-Alphonse^{1

3}, Sinthia Bosnic-Anticevich^{6

7

8}

Affiliations

¹ Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
² School of Medicine, The University of Notre Dame Australia, Sydney, Australia.
³ Sydney Pharmacy School, The University of Sydney, Sydney, Australia.
⁴ GSK Australia, Pty Ltd, Sydney, Australia.
⁵ Sydney Medical School, The University of Sydney, Sydney, Australia.
⁶ Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia. Sinthia.bosnic-anticevich@sydney.edu.au.
⁷ Sydney Pharmacy School, The University of Sydney, Sydney, Australia. Sinthia.bosnic-anticevich@sydney.edu.au.
⁸ Sydney Local Health District, Sydney, Australia. Sinthia.bosnic-anticevich@sydney.edu.au.

Abstract

Introduction: Correct inhaler technique is essential for the optimal delivery of inhaled medicines and the successfully management of respiratory conditions. The general practitioner (GP), the prescriber of inhaled medicines, plays a crucial role in educating patients on inhaler technique. However, in the real-world setting, there are barriers. For the GP, it is time and competence and for the patient, it is their ability to recognise inhaler technique as an issue and their ability to maintain correct inhaler technique over time. This study aimed to determine GPs' experience, skills and priority placed on inhaler technique and to identify factor(s) associated with inhaler technique competence.

Methods: This cross-sectional observational study design surveyed GPs' perspectives on inhaler use and preferences for inhaler prescribing within their practice setting. GP inhaler technique was assessed. GPs were recruited through an established network of GP practices. Data collected include (i) practice demographics, (ii) inhaler technique opinions and experience, (iii) inhaler prescribing preferences and (iv) inhaler education history data. Data were analysed descriptively and multivariate logistic regression modelling was used to explore the relationship between outcomes and GPs' ability to use devices correctly.

Results: A total of 227 GPs completed the inhaler survey. Sixty-three percent of GPs reported receiving previous inhaler education and 73.3% educated or checked their patients' inhaler technique; 64.5% felt they were somewhat competent in doing so. GPs who reported not demonstrating inhaler technique believed that a pharmacist or a practice nurse would do so. When prescribing new inhaler devices, GPs considered the disease being treated first and then patient's experience with inhalers; they often already have an inhaler preference and this was related to familiarity and perceived ease of use. For GPs, inhaler competence was not associated with their previous inhaler education or the priority placed on inhaler technique.

Conclusion: GPs do recognise the importance of inhaler technique in respiratory management but their technique can be better supported with regular educational updates to inform them about new inhalers and management practices and to support appropriate inhaler choices for their patients.

Keywords: Asthma; COPD; General practitioners; Inhaler technique; Training.