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Customized metered dose inhaler education improves skills for asthma, COPD patients

August 1, 2022

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Disclosure: Torrera does not report related financial disclosures. See research for relevant financial disclosures of all other authors.


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Customized metered-dose inhaler education was more effective compared with short-term interventions to improve inhaler technique in asthmatics, but may be less effective in those with lower health literacy. the researchers report Respiratory medicine.

“Currently, there is a growing elderly population in the United States, including a growing population at risk for COPD and asthma. Unfortunately, older patients have more asthma-related disease than middle-aged or young adults. It is clear that asthma outcomes are inferior because of the frequent emergency treatment of Christine C. Torrera medical doctor, An anesthesiologist in the Department of Anesthesiology and Critical Care Medicine at the Medical College of Chicago, and a colleague wrote, “In addition, inhaler misuse is one of the most important self-management problems for both asthma and COPD disease management in older patients.” It’s one.”


Data are from Trela ​​KC et al. respire med2022;doi:10.1016/j.rmed.2022.106930.

This study included 394 adult hospitalized patients with asthma or COPD (mean age 51.9 years, 67% female) from 5 prospective interventional studies conducted between 2007 and 2017. The participant received one simple verbal instruction without pre- or post-education evaluation or demonstration. Teaching towards goals (n = 189). A parent-centered, teach-back approach that uses demonstrations to deliver a series of assessments and education by trained educators. or virtual teach-to-goal (n = 142). Visual acuity, health literacy, and metered-dose inhalation skills were evaluated before and after educational intervention.

Researchers reported no significant differences in baseline metered dose inhaler misuse by age, visual acuity, or level of health literacy.

Nearly 47% of patients with low health literacy continued to misuse metered dose inhalers, compared to 23.9% of patients with high health literacy (P. < .001).

Patients with superior baseline metered dose inhaler skills, Teach-to-Goal or Virtual Teach-to-Goal education, and high health literacy were found to have less misuse after education .

Patients with lower health literacy received goal-oriented teaching and were three times more likely to misuse (33.3% vs. 11.6%; P. = .001), and those who received virtual goal-oriented education with low health literacy were 2.5 times more likely to misuse (50% vs. 19.7%; P. = .004) compared with patients with adequate health literacy. There was no significant difference in misuse rates among patients with high health literacy who received brief interventions (90.9% vs. 65.8%; P. = .1).

Higher health literacy and higher baseline metered dose inhaler skill scores increased the odds of post-educational misuse compared with patients with lower health literacy or poor baseline metered dose inhaler skills, respectively. decreased by 0.29 and 0.68. Participants who received goal-directed or virtual coaching education had reduced odds of misuse by 0.05 and 0.08, respectively, compared with patients who received short-term interventions.

“Future studies should investigate the relationship between age, health literacy and visual acuity in more detail, with a larger proportion of patients aged 65 years or older compared to our data. Other multivariate logistic models. By further developing the , priority should be given to creating patient-centered education for patients with low health literacy, as these patients are most vulnerable to post-education inhaler misuse and continue because it gives good clinical results.”

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