Assessment of inhaler technique among fourth-year pharmacy students: Implications for the use of entrustable professional activities

Educational Interventions in Immigrants for Asthma and COPD: A Systematic Review

Objective

Asthma and COPD are prevalent respiratory conditions among immigrants, yet many individuals in this population do not effectively utilize available therapies, resulting in exacerbations and limitations in their daily lives. This systematic review seeks to describe asthma/COPD educational interventions specifically tailored for immigrant patients and assess their variability and outcomes, with the ultimate goal of improving self-management and achieving better asthma or COPD control in this population.

Design

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A comprehensive literature search was conducted using four electronic databases (CINAHL, PubMed, Embase and PsycInfo). Articles were included if they focused on asthma or COPD interventions conducted in immigrant populations. The Mixed Methods Appraisal Tool was used to assess the quality of included articles.

Results

Out of the initial 1173 articles identified, 812 were assessed for eligibility. Six articles met the inclusion criteria for educational interventions targeting immigrants with asthma or COPD. These studies explored the effectiveness of interventions on various immigrant populations using different methodologies including group discussion of photographs and classroom-based interventions. The interventions varied in terms of settings, educational materials, and delivery methods. Positive outcomes were observed in areas such as knowledge, understanding of instructions, and inhaler technique. However, the included studies had limitations in assessing the impact on asthma and COPD self-management and sustainability.

Conclusion

More research is needed on asthma and COPD management in immigrants. The interventions included in this review had positive effects on outcomes like inhaler technique and asthma knowledge. However, due to variability in outcome measures, it is difficult to directly compare the interventions. Future studies should include diverse immigrant populations, consider the specific migration status of the immigrants, long-term sustainability of the intervention and use culturally tailored approaches to improve respiratory health in this population.

Mobile device: a useful tool to teach inhaler devices to healthcare professionals

BACKGROUND

Proper inhaler device usage is paramount for control of underlying obstructive airway disease. Hence, education to healthcare professionals who will eventually educate patients need to be done effectively. We developed an application for mobile devices for education on six medical inhaler devices, the metered-dose inhaler (MDI), Turbuhaler, Accuhaler, Breezhaler, Ellipta and Respimat, and studied if there were any difference between the application and the manufacturer's instructions on inhaler technique. The aim of this study is to see if inhaler education via a mobile phone app is comparable to manual instruction for health care professions.

METHODS

Participants, who were nursing students, were randomized to learn the inhaler devices via the manufacturer's instruction guide or a mobile device app designed specifically for education on inhaler devices.

RESULTS

There were 45 participants in each group. 78% of them were females with a median age of 21 (IQR 3). 67% used an Apple mobile device and the remainder used an Android device. The mobile device showed better total improvement points for the Turbuhaler device (262 vs 287 points; P = 0.02). Participants learning from the manufacturer's guide had a significantly higher total improvement points in the Breezhaler (370 vs 327 points; P < 0.01) and Ellipta (214 vs 174 points; P < 0.01) device. Both interventions showed improvement in total scores for demonstrating the correct usage of all inhaler devices. MDI has the least number of correct steps for both interventions. The participants' reported their mean (SD) self-rated knowledge was significantly higher for those using the app for all devices as compared to those that did not (4.33 (0.68) vs 4.73 (0.42); P = < 0.01). Self-reported confidence level was found to be higher in the mobile app group, but this was not statistically significant. The app was well received and scored of 4.42 of 5 with regards to its quality.

CONCLUSION

Using a mobile inhaler app is just as effective to teach inhaler device techniques to healthcare professionals and is likely a more convenient, versatile and important adjunct to learning.

TRIAL REGISTRATION

National Healthcare Group Ethics Board (2018/00960).

A Multi-Mode Education Program to Enhance Asthma Care by Pharmacists

Objective. To provide optimal asthma care, community pharmacists must have advanced, contemporary knowledge, and the skills to translate that knowledge into practice. The development and evaluation of an innovative multi-mode education program to enhance pharmacists' clinical knowledge and practical skills is described.Methods. The online education modules were collaboratively developed alongside asthma and pharmacy organizations. The education program was comprised of five evidence-based education modules delivered online and a skills review conducted either in-person with real-time feedback (urban pharmacists) or via video upload and scheduled video-conference feedback (regional and remote pharmacists). A mixed methods approach was used to evaluate the feedback obtained from pharmacists to assess the content, efficacy, and applicability of the education.Results. Ninety-seven pharmacists opted into the program and successfully completed all education requirements. A larger proportion of pharmacists did not pass trial protocol-based education modules on their first attempts compared to the number that passed the asthma and medication knowledge-based modules. Prior to skills review, the proportion of pharmacists demonstrating device technique competency was suboptimal. Pharmacists rated the education modules highly in both quantitative and qualitative evaluations and reported that the program adequately prepared them to better deliver care to asthma patients.Conclusion. We developed, implemented, and evaluated a novel multi-mode asthma education program for community pharmacists that supports knowledge and practical skill development in this crucial area of patient care. The education program was well received by pharmacists. This form of education could be used more broadly in international collaborative trials.