Axtell Samantha, Haines Seena, Fairclough Jamie
1 Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA.
J Pharm Pract. 2017 Apr;30(2):195-201. doi: 10.1177/0897190016628961. Epub 2016 Jul 9.
To compare the effectiveness of 4 different instructional interventions in training proper inhaler technique.
Randomized, noncrossover trial.
Health fair and indigent clinic.
Inhaler-naive adult volunteers who spoke and read English.
Subjects were assigned to complete the following: (1) read a metered dose inhaler (MDI) package insert pamphlet, (2) watch a Centers for Disease Control and Prevention (CDC) video demonstrating MDI technique, (3) watch a YouTube video demonstrating MDI technique, or (4) receive direct instruction of MDI technique from a pharmacist.
Inhaler use competency (completion of all 7 prespecified critical steps).
Of the 72 subjects, 21 (29.2%) demonstrated competent inhaler technique. A statistically significant difference between pharmacist direct instruction and the remaining interventions, both combined ( P < .0001) and individually ( P ≤ .03), was evident. No statistically significant difference was detected among the remaining 3 intervention groups. Critical steps most frequently omitted or improperly performed were exhaling before inhalation and holding of breath after inhalation.
A 2-minute pharmacist counseling session is more effective than other interventions in successfully educating patients on proper inhaler technique. Pharmacists can play a pivotal role in reducing the implications of improper inhaler use.
比较4种不同教学干预措施在培训正确吸入器使用技术方面的效果。
随机、非交叉试验。
健康博览会和贫困诊所。
从未使用过吸入器、会说英语和读英语的成年志愿者。
受试者被分配完成以下任务:(1)阅读定量吸入器(MDI)包装说明书小册子,(2)观看美国疾病控制与预防中心(CDC)演示MDI技术的视频,(3)观看YouTube上演示MDI技术的视频,或(4)接受药剂师对MDI技术的直接指导。
吸入器使用能力(完成所有7个预先指定的关键步骤)。
72名受试者中,21名(29.2%)展示了合格的吸入器技术。药剂师直接指导与其他干预措施(两者合并,P <.0001;单独比较,P≤.03)之间存在统计学显著差异。其余3个干预组之间未检测到统计学显著差异。最常被遗漏或执行不当的关键步骤是吸气前呼气和吸气后屏气。
在成功指导患者掌握正确吸入器技术方面,2分钟的药剂师咨询比其他干预措施更有效。药剂师在减少吸入器使用不当的影响方面可发挥关键作用。