Wrench Wendy, Van Dyk Lynette, Srinivas Sunitha, Dowse Ros
Faculty of Pharmacy, Rhodes University, Grahamstown.
Afr J Prim Health Care Fam Med. 2019 Aug 21;11(1):e1-e9. doi: 10.4102/phcfm.v11i1.2079.
Research globally has shown that metered dose inhaler (MDI) technique is poor, with patient education and regular demonstration critical in maintaining correct use of inhalers. Patient information containing pictorial aids improves understanding of medicine usage; however, manufacturer leaflets illustrating MDI use may not be easily understood by low-literacy asthma patients.
To develop and evaluate the outcome of a tailored, simplified leaflet on correct MDI technique in asthma patients with limited literacy skills.
A rural primary health care clinic in the Eastern Cape, South Africa.
Pictograms illustrating MDI steps were designed to ensure cultural relevance. The design process of the leaflet was iterative and consultative involving a range of health care professionals as well as patients. Fifty-five rural asthma patients were recruited for the pre-post design educational intervention study. Metered dose inhaler technique was assessed using a checklist, and patients were then educated using the study leaflet. The principal researcher then demonstrated correct MDI technique. This process was repeated at follow-up 4 weeks later.
The number of correct steps increased significantly post intervention from 4.6 ± 2.2 at baseline to 7.9 ± 2.7 at follow-up (p 0.05). Statistically significant improvement of correct technique was established for 10 of the 12 steps. Patients liked the pictograms and preferred the study leaflet over the manufacturer leaflet.
The tailored, simple, illustrated study leaflet accompanied by a demonstration of MDI technique significantly increased correct MDI technique in low-literacy patients. Patients approved of the illustrated, simple text leaflet, and noted its usefulness in helping them improve their MDI technique.
全球研究表明，定量吸入器（MDI）使用技巧欠佳，患者教育及定期演示对维持吸入器的正确使用至关重要。包含图片辅助的患者信息可提高对药物使用的理解；然而，说明MDI使用方法的厂家宣传册可能低文化水平的哮喘患者难以理解。
为文化水平有限的哮喘患者开发并评估一份关于正确MDI使用技巧的定制简化宣传册的效果。
南非东开普省的一家农村初级卫生保健诊所。
设计了说明MDI使用步骤的象形图以确保符合文化背景。宣传册的设计过程是反复且经过咨询的，涉及一系列医疗保健专业人员以及患者。招募了55名农村哮喘患者进行前后设计的教育干预研究。使用检查表评估定量吸入器使用技巧，然后使用研究宣传册对患者进行教育。首席研究员随后演示正确的MDI使用技巧。4周后的随访时重复此过程。
干预后正确步骤的数量从基线时的4.6±2.2显著增加到随访时的7.9±2.7（p<0.05）。12个步骤中有10个步骤的正确技巧有统计学意义的改善。患者喜欢象形图，并且比起厂家宣传册更喜欢研究宣传册。
配有MDI使用技巧演示的定制、简单、有插图的研究宣传册显著提高了低文化水平患者正确使用MDI的技巧。患者认可有插图的简单文字宣传册，并指出其有助于他们提高MDI使用技巧。
