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Inhaler technique mastery and maintenance in healthcare professionals trained on different devices

Bosnic-Anticevich, Sinthia; Callan, Christina; Chrystyn, Henry; Lavorini, Federico; Nikolaou, Vasilis; Kritikos, Vicky; Dekhuijzen, Richard P. N.; Roche, Nicolas; Bjermer, Leif LU and Rand, Cynthia, et al. (2017) In Journal of Asthma
Abstract

Objective: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). Methods: We conducted a randomized, un-blinded, crossover study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient information leaflet, instructional video, individual tuition from expert, then two repeats of individual tuition) for the use of Turbuhaler® (an established device) and Spiromax® (a newer device, reportedly easier to use). Device mastery (absence of errors)... (More)

Objective: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). Methods: We conducted a randomized, un-blinded, crossover study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient information leaflet, instructional video, individual tuition from expert, then two repeats of individual tuition) for the use of Turbuhaler® (an established device) and Spiromax® (a newer device, reportedly easier to use). Device mastery (absence of errors) was evaluated by expert assessors at each training step. Maintenance of mastery was assessed 4 ± 1 week (visit 2) and 8 ± 2 weeks (visit 3) after initial training (visit 1). Results: Of 516 eligible participants, 113 (22%) demonstrated device mastery prior to training on Spiromax® compared with 20 (4%) on Turbuhaler® (p < 0.001). The median number of training steps required to achieve mastery was 2 (interquartile range [IQR] 2–4) for Spiromax® and 3 (IQR 2–4) for Turbuhaler® (p < 0.001). A higher number of participants maintained mastery with Spiromax® compared with Turbuhaler®, at visits 2 and 3 (64% vs 41% and 79% vs 65%, respectively; p < 0.001). Conclusions: There are significant differences in the nature and extent of training required to achieve and maintain mastery for Spiromax® and Turbuhaler® devices. The implications on clinical practice, device education delivery, and patient outcomes require further evaluation.

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Contribution to journal
publication status
epub
subject
keywords
Asthma, clinical trial, device mastery, device mastery maintenance, dry powder inhaler, handling errors
in
Journal of Asthma
pages
10 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85018166340
ISSN
0277-0903
DOI
10.1080/02770903.2017.1310227
language
English
LU publication?
yes
id
c55fbade-6a11-45da-a2ff-fbb5f554796f
date added to LUP
2017-05-24 16:22:18
date last changed
2017-09-18 15:25:14
@article{c55fbade-6a11-45da-a2ff-fbb5f554796f,
  abstract     = {<p>Objective: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). Methods: We conducted a randomized, un-blinded, crossover study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient information leaflet, instructional video, individual tuition from expert, then two repeats of individual tuition) for the use of Turbuhaler® (an established device) and Spiromax® (a newer device, reportedly easier to use). Device mastery (absence of errors) was evaluated by expert assessors at each training step. Maintenance of mastery was assessed 4 ± 1 week (visit 2) and 8 ± 2 weeks (visit 3) after initial training (visit 1). Results: Of 516 eligible participants, 113 (22%) demonstrated device mastery prior to training on Spiromax® compared with 20 (4%) on Turbuhaler® (p &lt; 0.001). The median number of training steps required to achieve mastery was 2 (interquartile range [IQR] 2–4) for Spiromax® and 3 (IQR 2–4) for Turbuhaler® (p &lt; 0.001). A higher number of participants maintained mastery with Spiromax® compared with Turbuhaler®, at visits 2 and 3 (64% vs 41% and 79% vs 65%, respectively; p &lt; 0.001). Conclusions: There are significant differences in the nature and extent of training required to achieve and maintain mastery for Spiromax® and Turbuhaler® devices. The implications on clinical practice, device education delivery, and patient outcomes require further evaluation.</p>},
  author       = {Bosnic-Anticevich, Sinthia and Callan, Christina and Chrystyn, Henry and Lavorini, Federico and Nikolaou, Vasilis and Kritikos, Vicky and Dekhuijzen, Richard P. N. and Roche, Nicolas and Bjermer, Leif and Rand, Cynthia and Zwar, Nicholas and Price, David B.},
  issn         = {0277-0903},
  keyword      = {Asthma,clinical trial,device mastery,device mastery maintenance,dry powder inhaler,handling errors},
  language     = {eng},
  month        = {03},
  pages        = {10},
  publisher    = {Taylor & Francis},
  series       = {Journal of Asthma},
  title        = {Inhaler technique mastery and maintenance in healthcare professionals trained on different devices},
  url          = {http://dx.doi.org/10.1080/02770903.2017.1310227},
  year         = {2017},
}