Impact of Metered Dose Inhaler Technique Education in a Medical Out Patient Department

Abstract

Introduction: Asthma and Chronic Obstructive Pulmonary Disease (COPD) patients constitute a major portion of the inflow of a medical Out Patient Department (OPD). Incorrect use of Metered Dose Inhalers (MDI) is a significant barrier in improving the quality of medical care given to most patients with chronic respiratory diseases. Aim: This study was carried out to analyse the issues pertinent to incorrect MDI use and to assess the impact of a quality improvement initiative involving practical demonstration of correct technique using a standardized checklist. Materials and Methods: This was an interventional pre and post-test study conducted in medical OPD among COPD or asthma patients already on MDI. A baseline assessment of correctness of MDI use technique was done based on ADMITGINA guidelines, following which a practical demonstration of correct technique was done. These patients were followed up after one month and their technique was reassessed. The mean score was calculated for each patient pre and post intervention based on the correctness of steps and was compared using paired t-test. Results: Total 56 out of 102 patients completed the study. The mean score of MDI technique knowledge was 3.5±1.5, which increased to 6.7±1.2 after intervention (p<0.001). Only 27 (48.2%) patients reported having received prior educational training regarding MDI use and only 22 (39.3%) patients were using spacers. Conclusion: The current level of knowledge of correct steps of MDI use with spacer is low among patients. Practical demonstration of correct MDI use technique using a standardized checklist reduces errors in MDI use and thus helps in patient education.

Keywords

• asthma
• chronic obstructive pulmonary disease
• practical demonstration