The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients

Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Perumal R [verfasserIn] Leite M [verfasserIn] van Zyl-Smit RN [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	inhaler pressurised metered-dose inhaler clinical trials asthma copd

Übergeordnetes Werk:	In: International Journal of COPD - Dove Medical Press, 2009, (2020), Seite 1217-1224
Übergeordnetes Werk:	year:2020 ; pages:1217-1224

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ05194250X

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allfields	(DE-627)DOAJ05194250X (DE-599)DOAJ407687a0b8a54d2fbad6e741efabc8a0 DE-627 ger DE-627 rakwb eng RC705-779 Perumal R verfasserin aut The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD inhaler pressurised metered-dose inhaler clinical trials asthma copd Diseases of the respiratory system Leite M verfasserin aut van Zyl-Smit RN verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 1217-1224 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:1217-1224 https://doaj.org/article/407687a0b8a54d2fbad6e741efabc8a0 kostenfrei https://www.dovepress.com/the-relationship-between-clinical-trial-participation-and-inhaler-tech-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 1217-1224
spelling	(DE-627)DOAJ05194250X (DE-599)DOAJ407687a0b8a54d2fbad6e741efabc8a0 DE-627 ger DE-627 rakwb eng RC705-779 Perumal R verfasserin aut The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD inhaler pressurised metered-dose inhaler clinical trials asthma copd Diseases of the respiratory system Leite M verfasserin aut van Zyl-Smit RN verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 1217-1224 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:1217-1224 https://doaj.org/article/407687a0b8a54d2fbad6e741efabc8a0 kostenfrei https://www.dovepress.com/the-relationship-between-clinical-trial-participation-and-inhaler-tech-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 1217-1224
allfields_unstemmed	(DE-627)DOAJ05194250X (DE-599)DOAJ407687a0b8a54d2fbad6e741efabc8a0 DE-627 ger DE-627 rakwb eng RC705-779 Perumal R verfasserin aut The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD inhaler pressurised metered-dose inhaler clinical trials asthma copd Diseases of the respiratory system Leite M verfasserin aut van Zyl-Smit RN verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 1217-1224 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:1217-1224 https://doaj.org/article/407687a0b8a54d2fbad6e741efabc8a0 kostenfrei https://www.dovepress.com/the-relationship-between-clinical-trial-participation-and-inhaler-tech-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 1217-1224
allfieldsGer	(DE-627)DOAJ05194250X (DE-599)DOAJ407687a0b8a54d2fbad6e741efabc8a0 DE-627 ger DE-627 rakwb eng RC705-779 Perumal R verfasserin aut The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD inhaler pressurised metered-dose inhaler clinical trials asthma copd Diseases of the respiratory system Leite M verfasserin aut van Zyl-Smit RN verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 1217-1224 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:1217-1224 https://doaj.org/article/407687a0b8a54d2fbad6e741efabc8a0 kostenfrei https://www.dovepress.com/the-relationship-between-clinical-trial-participation-and-inhaler-tech-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 1217-1224
allfieldsSound	(DE-627)DOAJ05194250X (DE-599)DOAJ407687a0b8a54d2fbad6e741efabc8a0 DE-627 ger DE-627 rakwb eng RC705-779 Perumal R verfasserin aut The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD inhaler pressurised metered-dose inhaler clinical trials asthma copd Diseases of the respiratory system Leite M verfasserin aut van Zyl-Smit RN verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 1217-1224 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:1217-1224 https://doaj.org/article/407687a0b8a54d2fbad6e741efabc8a0 kostenfrei https://www.dovepress.com/the-relationship-between-clinical-trial-participation-and-inhaler-tech-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 1217-1224
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Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13&ndash; 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1&ndash; 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01&ndash; 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: &lt; 3 trials (aOR 0.35, 95% CI 0.19&ndash; 0.66) and &ge; 3 trials (aOR 0.17, 95% CI 0.07&ndash; 0.42). 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title	The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients
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title_full	The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients
author_sort	Perumal R
journal	International Journal of COPD
journalStr	International Journal of COPD
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author_browse	Perumal R Leite M van Zyl-Smit RN
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title_sort	relationship between clinical trial participation and inhaler technique errors in asthma and copd patients
callnumber	RC705-779
title_auth	The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients
abstract	Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD
abstractGer	Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD
abstract_unstemmed	Rubeshan Perumal,1 Marcia Leite,2 Richard Nellis van Zyl-Smit1,2 1Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa; 2UCT Lung Institute, University of Cape Town, Western Cape, South AfricaCorrespondence: Rubeshan Perumal Email rubeshanperumalgmail.comBackground: Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD.Methods: We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique.Results: During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breath-hold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95% CI 1.13– 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1– 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01– 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate: < 3 trials (aOR 0.35, 95% CI 0.19– 0.66) and ≥ 3 trials (aOR 0.17, 95% CI 0.07– 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience.Conclusion: This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and, in particular, multiple previous clinical trial participation significantly reduced the risk of errors.Keywords: inhaler, pressurised metered-dose inhaler, clinical trials, asthma, COPD
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title_short	The Relationship Between Clinical Trial Participation and Inhaler Technique Errors in Asthma and COPD Patients
url	https://doaj.org/article/407687a0b8a54d2fbad6e741efabc8a0 https://www.dovepress.com/the-relationship-between-clinical-trial-participation-and-inhaler-tech-peer-reviewed-article-COPD https://doaj.org/toc/1178-2005
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up_date	2024-07-03T23:00:57.233Z
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