Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Faculty of Medicine, Department of Internal Medicine, The University of Jordan, Amman, Jordan.
PLoS One. 2023 Jun 9;18(6):e0286870. doi: 10.1371/journal.pone.0286870. eCollection 2023.
Incorrect use of inhalers is a problem associated with poor patient outcomes. Despite improvement in the technique after verbal educations, this deteriorates over-time requiring re-enforcement through different educative strategies. This study aimed to assess the impact of a novel video-based teach-to-goal (TTG) educational intervention on: mastery of inhaler technique, disease control, medication adherence and disease-related quality of life (QoL) over-time among asthma and COPD patients.
This prospective, open-label, randomized controlled trial was registered in ClinicalTrials.gov: Identifier NCT05664347. After baseline assessment participants received either a verbal (control group) or a video-based (intervention group) TTG strategy. After 3-month the intervention was assessed for impact on the intended outcomes. Inhaler technique was assessed using standardized checklists, disease control using the Asthma control test and COPD assessment test respectively for asthma and COPD patients while adherence using the Morisky Green Levine scale. For QoL, the mini asthma quality of life questionnaire and the St. George respiratory questionnaire were used for asthmatic and COPD patients, respectively. Differences in outcomes between intervention-control groups were analyzed using either Chi-Square (X2)/Fisher Exact or Mann Whitney test. The impact of intervention on outcomes over-time was examined using either McNemar or Wilcoxon test.
At baseline, intervention (n = 51) and control (n = 52) groups had comparable demographic/clinical characteristics. At follow-up, inhaler technique improved among intervention group compared to control group (93.4% vs 67%) and to baseline (93.4% to 49.5%), (P<0.05). Similarly, medication adherence ameliorated among the intervention group in comparison to control group (88.2% to 61.5%) and to baseline (88.2% to 66.7%), (P<0.05). In regards to disease control, results showed an amelioration among the intervention group compared to baseline (35.3% to 54.9%) (P<0.05). QoL scores improved significantly among asthma patients (intervention group) at follow-up vs baseline. Better scores were also observed for COPD patients compared to controls, (P<0.05).
Video-based (TTG) was effective in enhancing inhaler technique over time as well as improving disease control, medication adherence, and QoL.
ClinicalTrials.gov: NCT05664347. https://clinicaltrials.gov/ct2/show/NCT05664347.
吸入器使用不当是导致患者预后不良的一个问题。尽管经过口头教育后，技术有所改善，但随着时间的推移，这种情况会恶化，需要通过不同的教育策略来加强。本研究旨在评估一种新的基于视频的目标导向（TTG）教育干预措施对哮喘和 COPD 患者的吸入器技术掌握、疾病控制、药物依从性和疾病相关生活质量（QoL）的影响：
这是一项前瞻性、开放标签、随机对照试验，已在 ClinicalTrials.gov 注册：标识符 NCT05664347。在基线评估后，参与者接受了口头（对照组）或基于视频的（干预组）TTG 策略。3 个月后，评估干预措施对预期结果的影响。使用标准化检查表评估吸入器技术，使用哮喘控制测试和 COPD 评估测试分别评估哮喘和 COPD 患者的疾病控制情况，而药物依从性则使用 Morisky-Green Levine 量表进行评估。对于 QoL，使用 mini asthma quality of life questionnaire 和 St. George respiratory questionnaire 分别评估哮喘和 COPD 患者的 QoL。使用卡方（X2）/Fisher 确切检验或曼-惠特尼检验分析干预组与对照组之间的结果差异。使用 McNemar 或 Wilcoxon 检验检查干预措施对随时间变化的结果的影响。
在基线时，干预组（n=51）和对照组（n=52）的人口统计学/临床特征具有可比性。在随访时，与对照组相比，干预组的吸入器技术得到了改善（93.4%比 67%），与基线相比也得到了改善（93.4%比 49.5%）（P<0.05）。同样，与对照组（88.2%比 61.5%）和基线相比（88.2%比 66.7%），干预组的药物依从性也有所改善（P<0.05）。在疾病控制方面，结果显示干预组与基线相比有所改善（35.3%比 54.9%）（P<0.05）。与基线相比，哮喘患者（干预组）在随访时的 QoL 评分显著提高。与对照组相比，COPD 患者的评分也有所改善（P<0.05）。
基于视频的（TTG）在随时间推移提高吸入器技术方面是有效的，同时也改善了疾病控制、药物依从性和 QoL。
ClinicalTrials.gov：NCT05664347。https://clinicaltrials.gov/ct2/show/NCT05664347。
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