EFFECTS OF INSTRUCTION BY PRACTICE ASSISTANTS ON INHALER TECHNIQUE AND RESPIRATORY SYMPTOMS OF PATIENTS - A CONTROLLED RANDOMIZED VIDEOTAPED INTERVENTION STUDY
S. Verver et al., EFFECTS OF INSTRUCTION BY PRACTICE ASSISTANTS ON INHALER TECHNIQUE AND RESPIRATORY SYMPTOMS OF PATIENTS - A CONTROLLED RANDOMIZED VIDEOTAPED INTERVENTION STUDY, Family practice, 13(1), 1996, pp. 35-40
Background. Many patients with asthma or chronic obstructive pulmonary
disease use their medication inhalers incorrectly. General practition
ers, pharmacists and other health care providers do not always have th
e opportunity to instruct patients in correct inhaler technique. Objec
tive. To find out whether the inhaler technique and respiratory sympto
ms of patients can be improved after instruction by practice assistant
s. Methods. Single blind, randomized intervention study in which 48 pa
tients who had been using a dry powder inhaler for at least one month
took part. Their inhaler technique was videotaped on two visits with a
two-week interval between visits. The inhaler technique on the videos
was subsequently scored by two experts on nine criteria. At both visi
ts the patients completed a questionnaire about their respiratory symp
toms. After the first video, 25 patients were randomly chosen to recei
ve instruction from one of six practice assistants who had followed a
one evening course about inhaler instruction, and who had been issued
an instruction-set. Results. The patients who received instruction had
a significantly greater reduction in number of mistakes at the second
visit than the patients who did not (P = 0.01). The instructed patien
ts also reported less dyspnoea at the second visit (P = 0.03). No effe
ct of instruction was found on wheezing, cough and sputum production.
Conclusion. The inhaler technique of patients can be improved signific
antly by the instruction of patients by trained practice assistants, p
ossibly resulting in less dyspnoea.