Valerie G. Press|Vineet M. Arora|Lisa M. Shah|Stephanie Lewis|Jeffery Charbeneau|Edward T. Naureckas|Jerry A. Krishnan
Teaching the Use of Respiratory Inhalers to Hospitalized Patients with Asthma or COPD: a Randomized Trial
University of Chicago Medical Center|University of Chicago Medical Center|Johns Hopkins Medicine|Johns Hopkins University|University of Illinois Hospital & Health Sciences System|University of Illinois at Chicago|University of Illinois Hospital & Health Sciences System|University of Illinois at Chicago|University of Chicago|University of Illinois Hospital & Health Sciences System|University of Illinois at Chicago
hospitalized patients frequently misuse respiratory inhalers yet unclear effective hospitalbased educational intervention populationto compare two strategies teaching inhaler use hospitalized patients asthma chronic obstructive pulmonary disease copda phaseii randomized controlled clinical trial enrolled hospitalized adults physician diagnosed asthma copdhospitalized adults age 18 years older asthma copdparticipants randomized brief intervention bi singleset verbal written stepbystep instructions teachtogoal ttg bi plus repeated demonstrations inhaler use participant comprehension assessments teachbackthe primary outcome metereddose inhaler mdi misuse postintervention 75 steps correct secondary outcomes included diskus misuse selfreported inhaler technique confidence prevalence 30day healthrelated eventsof 80 eligible participants fifty 63 enrolled bi n26 ttg n24 majority participants reported confident inhaler technique mdi 70 diskus 94 misused inhalers preintervention mdi 62 diskus 78 postintervention mdi misuse significantly lower ttg vs bi 125 vs 46 p001 results diskus similar approached significance 25 vs 80 p005 participants 30day acute healthrelated events less common group receiving ttg vs bi 1 vs 8 p002ttg appears effective compared bi patients overestimate inhaler technique emphasizing need hospitalbased interventions correct inhaler misuse although ttg associated fewer posthospitalization healthrelated events larger multicentered studies needed evaluate durability clinical outcomes associated hospitalbased education