Journal List > Tuberc Respir Dis > v.63(6) > 1001174

TOOLS
Yu, Park, Park, Park, Kim, Kim, Shin, Chung, and Lee: The Effect of Repeated Education using a Computerized Scoring System for the Proper Use of Inhalation Medicine
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(6): 491-496.

Published online: 31 December 2007

DOI: https://doi.org/10.4046/trd.2007.63.6.491

The Effect of Repeated Education using a Computerized Scoring System for the Proper Use of Inhalation Medicine

Sung Ken Yu, M.D.1, Sung Im Park2, So Young Park2, Jung Kyu Park2, Sung Eun Kim2, Jung Youp Kim3, Kyeong Cheol Shin, M.D.1, Jin Hong Chung, M.D.1, Kwan Ho Lee, M.D.1

1Department of Internal Medicine, College of Medicine, Yeungnam University, Korea.

2Department of Pharmacy, Yeungnam University Medical Center, Korea.

3Department of Elderly Welfare, Daegu Haany University, Daegu, Korea.

Address for correspondence: Kwan Ho Lee, M.D. Department of Internal Medicine, College of Medicine, Yeungnam University, 317-1, Daemyeong-dong, Nam-gu, Daegu 705-717, Korea. Phone: 82-53-620-3838, Fax: 82-53-654-8386, ghlee@med.yu.ac.kr

Received 13 September 2007       Accepted 20 November 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

The best way of delivering drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD) is via the inhaled route of administration. However, many patients use inhaler devices incorrectly. To augment the proper use of inhalation medicine and to improve knowledge of the disease and compliance, we have developed a "Computerized Respiratory Service Program" and applied the use of this program to educate patients.

Methods

Prospectively, this study was performed in 164 patients with asthma or COPD prescribed with inhaled medication. When inhalation medication was first prescribed, education using a drug model was conducted two times and thereafter every month. In addition, education using a drug model was conducted and the ability of the patient to use inhalation medicine properly was evaluated.

Results

A total of 164 patients participated in the sessions more than two times and received education. Fifty-seven patients participated in three sesions. After the patients received education one time, the ability of these patients to use an inhaler had an average score of 20.6. After the patients received education two times, the average score was 21.9. After the patients received education three times, the average score was 22.3, a further increase. The compliance of using the inhaler was 70.1% at the second session and increased to 81.8% at the third session.

Conclusion

Feedback education using the "Computerized Respiratory Service Program" will increase the ability of the patient to use an inhaler and consistent education can maintain patient compliance with inhaler use.

Keywords: Chronic obstructive pulmonary disease, Asthma, Inhaler, Computerized respiratory service program

Figures and Tables

Figure 1
EMR page specialized for an education using an inhaler.
trd-63-491-g001
Figure 2
Electric chart for education and evaluation of the patient's using ability of inhaler.
trd-63-491-g002
Figure 3
At steps, the change of scores between 1st visit and 2nd visit (total mean change, The largest change of steps, The smallest change of steps).
trd-63-491-g003
Figure 4
The score of correctly performing inhaled medications on feedback education.
trd-63-491-g004
Table 1
Checklist for handling of inhaler
trd-63-491-i001

MDI: Metered dose inhaler; DPI: Dry powder inhaler.

Table 2
Points of patients performing each step at first visit
trd-63-491-i002

MDI: Metered dose inhaler; DPI: Dry powder inhaler; SD: Standard deviation.

Table 3
Difference of using ability of inhaler between metered dose inhaler and dry powder inhaler
trd-63-491-i003

SD: Standard deviation.

Table 4
Understanding action mechanism of inhaler medication
trd-63-491-i004
Table 5
Understanding of the difference between controller and reliever
trd-63-491-i005
Table 6
Compliance of inhaler medication
trd-63-491-i006
Table 7
Causes of irregular use
trd-63-491-i007

References

1. Cochrane MG, Bala MV, Downs KE, Mauskopf J, Ben-Joseph RH. Inhaled corticosteroids for asthma therapy: patient compliance, devices, and inhalation technique. Chest. 2000. 117:542–550.
2. Molimard M, Raherison C, Lignot S, Depont F, Abouelfath A, Moore N. Assessment of handling of inhaler devices in real life: an observational study in 3,811 patients in primary care. J Aerosol Med. 2003. 16:249–254.
3. Hesselink AE, Penninx BW, Wijnhoven HA, Kriegsman DM, van Eijk JT. Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scand J Prim Health Care. 2001. 19:255–260.
4. Hanania NA, Wittman R, Kesten S, Chapman KR. Medical personnel's knowledge of and ability to use inhaling devices. Metered-dose inhalers, spacing chambers, and breath-actuated dry powder inhalers. Chest. 1994. 105:111–116.
5. Cochrane GM. Therapeutic compliance in asthma: its magnitude and implications. Eur Respir J. 1992. 5:122–124.
6. Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J. 2002. 19:246–251.
7. Newman SP, Weisz AW, Talaee N, Clarke SW. Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique. Thorax. 1991. 46:712–716.
8. van Beerendonk I, Mesters I, Mudde AN, Tan TD. Assessment of the inhalation technique in outpatients with asthma or chronic obstructive pulmonary disease using a metered-dose inhaler or dry powder device. J Asthma. 1998. 35:273–279.
9. Horsley MG, Bailie GR. Risk factors for inadequate use of pressurized aerosol inhalers. J Clin Pharm Ther. 1988. 13:139–143.
10. Kamps AW, Brand PL, Roorda RJ. Determinants of correct inhalation technique in children attending a hospital-based asthma clinic. Acta Paediatr. 2002. 91:159–163.
11. Tsang KW, Lam WK, Ip M, Kou M, Yam L, Lam B, et al. Inability of physicians to use metered-dose inhaler. J Asthma. 1997. 34:493–498.
12. Gallefoss F, Bakke PS. How does patient education and self-management among asthmatics and patients with chronic obstructive pulmonary disease affect medication? Am J Respir Crit Care Med. 1999. 160:2000–2005.
13. van der Palen J, Klein J, Rovers M. Compliance with inhaled medication and self-treatment guidelines following a self-management programme in adult asthmatics. Eur Respir J. 1997. 10:652–657.
TOOLS
Similar articles