Anne C. Melzer|Bijan J. Ghassemieh|Suzanne Gillespie|Peter K. Lindenauer|Mary Ann McBurnie|Richard A. Mularski|Edward T. Naureckas|William M. Vollmer|David H. Au
Patient characteristics associated with poor inhaler technique among a cohort of patients with COPD
VA Puget Sound Health Care System|Pulmonary and Critical Care Associates|University of Washington|Pulmonary and Critical Care Associates|University of Washington|Kaiser Permanente Center for Health Research|Baystate Medical Center|Kaiser Permanente Center for Health Research|Kaiser Permanente Center for Health Research|University of Chicago|Kaiser Permanente Center for Health Research|Pulmonary and Critical Care Associates|University of Washington|VA Puget Sound Health Care System
backgroundinhaled therapies cornerstone pharmacologic management copd device requires unique series steps effective making appropriate instruction inhaler technique key part management copdobjectivesexamine characteristics patients devices associated poor technique among patients copdmethodscrosssectional study subjects copd using least one metered dose inhaler advair diskus spiriva handihaler identified copd outcomesbased network clinical effectiveness research translation concert registry technique assessed facetoface using manufacturerprovided dummy inhalers standardized checklists device used logistic regression model associations poor inhaler technique defined error 20 steps function patient characteristics educational attainment primary predictorresults688 individuals meet eligibility criteria 655 poor technique least one device adjusted analyses black race associated poor technique 325 95ci 186567 greater high school education associated decreased odds poor technique 035 95ci 017070 trade schoolsome college 025 95ci 011061 college p 0001 test linear trend percentage errors varied devices subjects making proportionally errors mdisconclusionspoor inhaler technique common among individuals copd varies devices associated race educational attainment tailored educational interventions teach inhaler technique part process initiating monitoring inhaled therapies