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- DOI 10.18231/j.ijirm.12281.1875167832
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CrossMark
Perspective of asthma patients on inhalation devices: Scenario from Urban India
- Author Details:
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Tushar Ramesh Sahasrabudhe
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Atulya Anand *
Tushar Ramesh Sahasrabudhe
Atulya Anand *
Background: Inhalation devices are the cornerstone of asthma management, providing targeted drug delivery to the airways with minimal systemic effects. Despite advances in device design and patient education, incorrect inhaler technique and poor device maintenance remain widespread, impacting disease control.
Objective: To evaluate patient perspectives on inhalation devices, assess inhalation technique, device preferences, and device care practices among asthma patients in an urban Indian setting.
Materials and Methods: An observational study was conducted among 182 adult asthma patients at a tertiary care teaching hospital. Participants who received device training within past one month, were assessed using standardized inhaler technique checklists and Asthma Control Test (ACT). Device preferences and maintenance practices were inquired into.
Results: Dry powder inhalers (DPIs) were preferred by 69.8% of participants. Elderly patients preferred pressurized metered dose inhalers (pMDIs) with spacers. Technique correctness scores were 8.40 ± 0.718 for DPI and 7.99 ± 0.839 for pMDI users out of 10. Not holding breath for adequate time after inhalation and failure to rinse/ gargle remained the most notable and important errors. Patients with lower technique scores showed poorer asthma control (ACT ≤19). 57.14% of participants reported not cleaning their devices at all.
Conclusion: Despite recent training, significant technique and device care errors occurred, emphasizing the need for repeated training and reinforcement. Proper device maintenance is important to improve adherence and optimize asthma control.
References
- Agarwal R, Dhooria S, Aggarwal AN, Maturu VN, Sehgal IS, Muthu V, et al. Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations. Lung India. 2015;32(Suppl 1):S3–S42.
- Dolovich MB, Ahrens RC, Hess DR, Anderson P, Dhand R, Rau JL, et al. Device selection and outcomes of aerosol therapy: evidence-based guidelines. Chest. 2005;127(1):335–371.
- 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 3811 patients in primary care. J Aerosol Med. 2003;16(3):249–54.
- Sanchis J, Gich I, Pedersen S, Aerosol Drug Management Improvement Team (ADMIT). Systematic review of errors in inhaler use: has patient technique improved over time? Chest. 2016:150(2):394–406.
- Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930–8.
- Price D, Bosnic-Anticevich S, Briggs A, Chrystyn H, Rand C, Scheuch G, et al. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respir Med. 2013;107(1):37–46.
- Molimard M, Le Gros V. Impact of patient-related factors on asthma control. J Asthma. 2008;45(2):109–13.
- Mäkelä MJ, Backer V, Hedegaard M, Larsson K. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. Respir Med. 2013;107(10):1481–90.
- Chrystyn H, Price D. Not all asthma inhalers are the same: factors to consider when prescribing an inhaler. Prim Care Respir J. 2009;18(4):243–9.
- Usmani OS, Lavorini F, Marshall J, Dunlop WCN, Heron L, Farrington E, et al. Critical inhaler errors in asthma and COPD: A systematic review of impact on health outcomes. Respir Res. 2018;19(1):10.
- Matsunaga K, Yamagata T, Minakata Y, Ichinose M. Importance of assistance by caregivers for inhaled corticosteroid therapy in elderly patients with asthma. J Am Geriatr Soc. 2006;54(10);1626–7.
- Basheti IA, Reddel HK, Armour CL, Bosnic-Anticevich SZ. Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists. J Allergy Clin. Immunol. 2007;119(6):1537–38.
- Sahasrabudhe TR, Oswal VS, Joshi M, Khan A. Impact of single training session on correct use of inhalation devices and asthma control. Am J Respir Crit Care Med. 2012;185:A2880.
- Dhadge N, Shevade M, Narke G, Pathak D, Shastri N, Barne M, et al. Evaluation of the technique of use of inhaler devices by patients at home through a video mobile application: A pilot study. Eur Respir J. 2019;54(suppl 63):PA5027.
- Van der Palen J, Klein JJ, Kerkhoff AH, van Herwaarden CL, Seydel ER. Inhalation technique of 305 patients with asthma or COPD: subgroup analysis of inhalation devices. J Asthma. 1999;36(4):351–
- Akhoon N, Brashier DB. A study to monitor errors in use of inhalation devices in patients of mild-to-moderate bronchial asthma in a tertiary care hospital in Eastern India. J Family Med Prim Care. 2019;8(9):2896–901.
- Crompton GK, Barnes PJ, Broeders M, Corrigan C, Corbetta L, Dekhuijzen R, et al. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med. 2006;100(9):1479–94.
- Al-Jahdali H, Ahmed A, Al-Harbi A, Khan M, Baharoon S, Bin Salih S, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol. 2013;9(1):8.
- Boulet LP, Boulay ME, Gauthier G, Battisti L, Chabot V, Beauchesne MF, et al. Benefits of an asthma education program provided at primary care sites on asthma outcomes. Respir Med. 2015;109(8):991–1000.