Abstract
INTRODUCTION: The aims of this study were (1) to assess the ability of a range of health-care professionals (HCPs: specialists [physicians specializing in management of airways disease], general practitioners, pharmacists, pharmacist assistants, nurses, and respiratory therapists) in Jordan to demonstrate the correct use of some commonly used inhalers using standardized checklists, with highest scores indicating optimal use, and (2) to evaluate the short-term and long-term effectiveness of a single educational intervention on the HCPs' skills in using inhalers.
METHODS: HCPs' inhaler technique was assessed at baseline. All HCPs were then invited to attend a workshop on asthma management with particular reference to inhaler use. At the workshop, HCP skills in inhaler technique were optimized. Inhaler technique was assessed before and after training. All participants were assessed on their inhaler technique at follow-up (after 4 months).
RESULTS: Two hundred HCPs (10 specialists, 46 general practitioners, 79 pharmacists, 15 pharmacist assistants, 40 nurses, and 10 respiratory therapists) participated in the study. Specialists scored highest on baseline inhaler technique demonstration skills. All HCPs scored poorly in demonstrating the correct use of the dry powder inhalers when compared with pressurized metered-dose inhalers (MDIs) (range of mean scores ± SD: MDI, 7.24 ± 0.97 to 8.70 ± 0.67; Diskus, 4.83 ± 0.51 to 6.30 ± 1.7; Turbuhaler, 4.90 ± 0.32 to 6.40 ± 1.7). Participants attending the workshop showed improved inhaler skills (mean scores before and after training: MDI, 4.77 ± 1.60 vs 8.77 ± 0.52; Diskus, 4.40 ± 2.60 vs 8.85 ± 0.41; Turbuhaler, 4.96 ± 2.05 vs 8.63 ± 0.67). Four months after the workshop, the inhaler technique of 129 participants was again assessed. Those who had attended the workshop (n = 48) scored significantly higher mean scores for all devices (score = 7.64) than nonattendees (n = 81, score = 5.99, P < .001), by one-way analysis of covariance.
CONCLUSIONS: With the exception of specialists, HCPs in Jordan need to be updated on their inhaler technique skills, specifically the newer dry powder inhalers. A single effective educational workshop on inhaler technique can significantly improve HCPs' long-term ability to demonstrate these skills.
Footnotes
- Correspondence: Iman A Basheti PhD, Department of Clinical Pharmacy and Therapeutics, Applied Science University, Amman 11931, Jordan. E-mail: dr_iman{at}asu.edu.jo.
Supplementary material related to this paper is available at http://www.rcjournal.com.
Dr Basheti presented this research in poster format at the 15th Scientific Congress of the Association of Pharmacy Colleges in the Arab World and 3rd International Conference of the Faculty of Pharmacy–The University of Jordan, held October 9–11, 2012, in Amman, Jordan; and at the Al-Zaytoonah University of Jordan and the University of Toledo International Pharmaceutical Conference (ZTIPC 2012), held October 17–19, 2012, in Amman, Jordan.
The workshop costs were sponsored by AstraZeneca Jordan. GlaxoSmithKline provided placebo Diskus, pressurized metered-dose inhalers, and flow meters; AstraZeneca provided placebo Turbuhalers. Dr Reddel has provided independent medical education at symposia funded by AstraZeneca, GlaxoSmithKline, and Novartis; has participated in advisory boards for AstraZeneca, GlaxoSmithKline, Novartis, and Boehringer Ingelheim; has provided consultancy for GlaxoSmithKline; is participating in a joint data monitoring committee for studies funded by AstraZeneca, GlaxoSmithKline, Merck, and Novartis; and has received unconditional grants from AstraZeneca and GlaxoSmithKline for investigator-sponsored research. The other authors have disclosed no conflicts of interest.
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