A study to monitor errors in use of inhalation devices in patients of mild-to-moderate bronchial asthma in a tertiary care hospital in Eastern India

Abstract

Context: Bronchial asthma is a chronic respiratory disorder which affects over 300 million people worldwide. Inhalation pharmacotherapy is the cornerstone in treatment of asthma, which is administered using inhaler devices. Studies show high prevalence of incorrect technique while inhaler usage, which renders to compromised disease control and increased healthcare cost. Aims: This study was aimed to monitor errors in use of inhalers and explore their relationship with patient characteristics and training given by healthcare providers, in patients suffering from mild to moderate bronchial asthma. Settings and Design: This was an observational cross-sectional study conducted after approval of Institutional ethics committee in a tertiary care hospital. Methods and Material: A total of 207 patients were recruited after they met the inclusion criteria and their informed consent was taken. Data regarding the patients' socio-demographic information, education status and history of illness were logged on a case record form. Their inhalation techniques were assessed according to the checklist, errors were noted and patients were educated regarding correct technique using 'teach-back training' method. Statistical analysis used: Chi-square test, SPSS software. Results: Among the inhalers used, pMDI was most commonly prescribed (58%), followed by DPI (37.7%) and pMDI with spacer (4.3%). Irrespective of the type of inhaler used, overall 75.36% patients included in the study, showed errors in use of inhaler. Prevalence of errors in DPI, pMDI and pMDI with spacers was 78.2 %,77.8% and 22.2% respectively. Our study showed that education status of patient, training by healthcare provider and duration of inhaler use have statistically significant association (p< 0.05) with the prevalence of errors in inhaler usage. Conclusion: It is emphasized that dedicated and trained staff should be available for instructing patients and reinforcing by follow up checks should be considered.