Volume : 9, Issue : 4, April - 2020

Assessment of Inhaler technique for MDI in COPD patients attending Nalanda Medical College & Hospital; A Tertiary Care Teaching Hospital of Bihar

Dr. Jwala Kumar, Dr. Prof. Sanjay Kumar, Dr. Nadia Az Zahra

Abstract :

Background: Inhaled medications are cornerstone for the management of chronic obstructive pulmo¬nary disease (COPD) and MDI (metered dose inhaler) is most commonly prescribed inhaler. The correct use of inhaler is very important aspect to be considered when evaluating the progress of disease treatment in COPD patients. Incorrect inhaler technique is associated with decreased drug deposition in the airway and so poor disease control & greater systemic side effect. Incorrect technique of inhaler use was reported in more than 80% of patients. The aim of this study was to assess inhaler tech¬nique of MDI amongst COPD patient attending Nalanda Medical College & Hospital, Patna. Methods: A prospective observational study was conducted in which through a face to face interview assessment of inhaler technique was performed. We developed a checklist of steps (total 8) of correct use of MDI on the basis of instruction provided by the manufacturer. When one or more steps were wrong, technique was defined as incorrect. Results: Total 80 patients (mean age 60.1 year) were evaluated. Fifty-eight patients (72.5%) performed at least one step incorrectly and we designated them wrong technique. Thus only 27.5% patient correctly demonstrated all steps. The most frequent error in handling the MDI was the step “eath out gently to residual volume”. A lower percentage of incorrect inhaler technique in patients with higher education was observed. We also observed a lower percentage of incorrect inhaler technique in the elderly. Our data also suggest that females when compared to male present lower incorrect inhaler technique. Our study also found lower percentage of incorrect inhaler technique if patient were trained by doctor and it was highest if trained by pharmacist. Conclusion: Incorrect use of MDI is very common among COPD patients. So, inhaler technique in COPD patient needs face-to-face training which should be done preferably by doctor himself or by a trained nurse at each visit, specially before changing the treatment regimen.