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Thebault JL, Pecqueur R, Teixeira AP. [Assessment of general practitioners' knowledge of inhalers]. Rev Mal Respir 2021; 38:873-881. [PMID: 34462151 DOI: 10.1016/j.rmr.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 07/02/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Inhaled drug delivery is the cornerstone treatment for asthma. General practitioners (GPs) have a key role for educating patient about how to use their inhalers. The purpose of this study was to find out whether GPs know how to use the inhalers they usually prescribe. METHOD This was a descriptive and analytical cross-sectional study among GPs from the Paris metropolitan area. GPs had to choose the inhalers they usually prescribe and then demonstrate their use. The technique of use was assessed using a scale specific to each type of inhaler. Overall success was defined by the use of prescribed inhalers without critical errors. RESULTS Thirty-seven GPs were recruited between July 2018 and July 2019. Nineteen GPs (51.4%) were able to use the inhalers they prescribed without critical errors. The success rate without critical error was better with the pressurized metered dose inhalers with spacer than with other inhalers. The overall success rate was better among GPs who had previously used an inhaler on a personal basis (OR 7.58 95%CI [1.86, 37.02]) or who had prescribed only one type of inhaler (OR 4,8 95%CI [1.21, 22.41]). CONCLUSION Half of the GPs in our study did not know how to use the inhalers they prescribe and therefore may have difficulty educating their patients.
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Affiliation(s)
- J-L Thebault
- Département de médecine générale, faculté de Santé, UFR de médecine Paris Centre, université de Paris, 24 rue du faubourg Saint-Jacques, 75014 Paris, France.
| | - R Pecqueur
- Département de médecine générale, faculté de Santé, UFR de médecine Paris Centre, université de Paris, 24 rue du faubourg Saint-Jacques, 75014 Paris, France
| | - A P Teixeira
- Service de pneumologie, allergologie, oncologie thoracique, Groupe Hospitalier Saint-Joseph, 75014 Paris, France
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Iraqi B, Jroundi I, Iraqi A, Mahraoui C. The pharmacist's role in managing and ameliorating childhood's asthma care: a descriptive and transversal study about 104 pharmacists in the city of Rabat in Morocco. Pan Afr Med J 2018; 30:101. [PMID: 30364337 PMCID: PMC6195242 DOI: 10.11604/pamj.2018.30.101.11593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/12/2018] [Indexed: 12/05/2022] Open
Abstract
This work aims at enhancing the management of childhood asthma, with a focus on pharmacists in particular, by evaluating their knowledge of childhood asthma and assessing their attitude while they are providing asthma medicines. Consequently, it will look at the necessity of introducing training days about childhood asthma for pharmacists. This is a transversal and descriptive study which lingered from August to October 2015. Data has been collected using a questionnaire that was self-administered to every surveyed pharmacist in the city of Rabat. The 104 pharmacists who replied to the questionnaire have an average general understanding about asthma and its treatment. Only a quarter of them managed an asthma crisis in their pharmacy before directing the child to the emergency. 50% of them do not know the difference between the basic asthma therapy and the asthma attack therapy. However, all of them recommended the parents to see a physician regarding their child’s asthma. 75% advise the systematic use of an asthma spacer with the inhaler. 87.5% of them give advice to parents regarding the good measures for environmental control, and 98% estimate that the therapeutic education is important in childhood asthma management. 88.5% among them are interested in training days about childhood asthma.This study shows the necessity of further pharmacists’ education about asthma and its management.
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Affiliation(s)
- Bousayna Iraqi
- Pediatric Pulmonary and Allergic Diseases Unit, Ibn Sina Children's University Hospital, Rabat, Morocco
| | - Imane Jroundi
- Unit of Research and Training of Public Health, School of Medicine and Pharmacy University Mohammed V, Rabat, Morocco
| | - Amina Iraqi
- King Fahd School of Translation-Tangier, Morocco
| | - Chafiq Mahraoui
- Pediatric Pulmonary and Allergic Diseases Unit, Ibn Sina Children's University Hospital, Rabat, Morocco
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Plaza V, Giner J, Rodrigo GJ, Dolovich MB, Sanchis J. Errors in the Use of Inhalers by Health Care Professionals: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:987-995. [PMID: 29355645 DOI: 10.1016/j.jaip.2017.12.032] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/15/2017] [Accepted: 12/30/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Inefficient inhaler technique (IT) compromises the optimal delivery of medication. However, the IT knowledge of health care professionals (HCPs) has received scant attention. OBJECTIVE The objective of this study was to perform a systematic review of published reports assessing the IT proficiency of HCPs in using pressurized metered dose (pMDI) and dry powder (DPI) inhalers. METHODS Studies published between 1975 and 2014 that directly assessed the IT skills of HCPs were selected according to predefined selection criteria. RESULTS Data were extracted from 55 studies involving 6,304 HCPs who performed 9,996 tests to demonstrate their IT proficiency. Overall, the IT was considered correct in 15.5% of cases (95% confidence interval [CI], 12-19.3), decreasing over time from 20.5% (95% CI, 14.9-26.8) from the early period (defined as 1975-1995) to 10.8% (95% CI, 7.3-14.8) during the late period (1996-2014). The most common errors in the use of pMDIs were as follows: not breathing out completely before inhalation (75%; 95% CI, 56-90), lack of coordination (64%; 95% CI, 29-92), and postinhalation breath-hold (63%; 95% CI, 52-72). The most common errors using DPI were deficient preparation (89%; 95% CI, 82-95), not breathing out completely before inhalation (79%; 95% CI, 68-87), and no breath-hold (76%; 95% CI, 67-84). CONCLUSIONS HCPs demonstrated inadequate knowledge of the proper use of inhalers. The poor understanding of the correct use of these devices may prevent these professionals from being able to adequately assess and teach proper inhalation techniques to their patients.
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Affiliation(s)
- Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Jordi Giner
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gustavo J Rodrigo
- Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay
| | - Myrna B Dolovich
- Department of Medicine, Division of Respirology, St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Joaquin Sanchis
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
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Casset A, Meunier-Spitz M, Rebotier P, Lefèvre H, Barth C, Heitz C, de Blay F. Asthma management and inhalation techniques among community pharmacists in 2009: a comparison with the 1999 survey. J Asthma 2014; 51:964-73. [PMID: 24986249 DOI: 10.3109/02770903.2014.936446] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In a 1999 survey, community pharmacists from the Alsace region of France had a reasonably good knowledge of asthma treatment and prevention, but their skill in the use of asthma inhalation devices left room for improvement. Since then, health authorities have encouraged the involvement of community pharmacists in patient care and education in order to improve asthma control. The aim of this study was to assess the change in the knowledge of asthma management and inhaler technique skills of community pharmacists in the same geographic area after a 10-year interval. METHODS In 2009, 86 randomly selected community pharmacists from the Alsace region answered a standardized questionnaire about their theoretical knowledge of and practical attitude toward asthma management and inhaled delivery systems, following which their skills in the use of four inhalation devices (pressurized metered-dose inhaler (pMDI) with/without a spacer, breath-actuated pMDI and dry powder inhaler (DPI)) were evaluated. RESULTS Very few pharmacists were required to manage an acute asthma exacerbation at the pharmacy, but all responded well by administering a short-acting inhaled β2-agonist. Theoretical knowledge of asthma management (criteria of severity of asthma exacerbation, guidelines and drugs triggering asthma exacerbations) was still average. Compared with 1999, they were twice as confident in demonstrating inhaler use, and their skills in using the pMDI, breath-actuated pMDI and DPI had improved significantly (p < 0.001). CONCLUSIONS Since 1999, pharmacists' skill in the use of inhalers has improved, but theoretical knowledge of asthma management is still average, pointing to the importance of continuing pharmaceutical education.
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Affiliation(s)
- Anne Casset
- Laboratory of Conception and Application of Bioactive Molecules, CNRS-University of Strasbourg , Faculty of Pharmacy, Illkirch , France
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Badoum G, Toloba Y, Thiombiano R, Ouédraogo G, Ouédraogo M. [Attitude of private pharmacists in the dispensation of asthma drugs]. Rev Mal Respir 2013; 32:18-23. [PMID: 25618200 DOI: 10.1016/j.rmr.2013.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Despite recommendations, asthma remains poorly controlled in many countries. Asthmatic patients see pharmacy staff regularly to obtain medications. The aim of this study was to evaluate the attitude of pharmacists in Burkina Faso about dispensing asthma drugs. METHOD A self-administered anonymous questionnaire was used to collect data in a descriptive cross-sectional study related to pharmacists' attitudes in the management of asthma in the city of Ouagadougou (November 2010-June 2011). RESULTS The rate of participation of pharmacists in the study was 82.4%. Of the pharmacists surveyed, 70.1% reported having received asthma patients both during acute asthma exacerbations and when stable. Only 9% of pharmacists insisted on a prescription when asthma patients came to the pharmacy without one. A total of 73.6% of pharmacists explained and demonstrated how to use the spray to the patients. Among pharmacists who demonstrated how to use devices, only 6.7% actually checked patients' technique. Inhaler technique demonstration was done verbally in 68.8% of case. Among pharmacists, 34.5% reported a good mastery of inhaler techniques. CONCLUSION The techniques for dispensing asthma drugs are not well established among pharmacists and therefore the provision of continuous medical education to pharmacists is important.
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Affiliation(s)
- G Badoum
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
| | - Y Toloba
- Service de pneumologie, CHU Point G, Bamako, Mali
| | - R Thiombiano
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - G Ouédraogo
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - M Ouédraogo
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
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Lee SM, Chang YS, Kim CW, Kim TB, Kim SH, Kwon YE, Lee JM, Lee SK, Jeong JW, Park JW, Cho SH, Moon HB, Jee YK. Skills in handling turbuhaler, diskus, and pressurized metered-dose inhaler in korean asthmatic patients. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2010; 3:46-52. [PMID: 21217925 PMCID: PMC3005319 DOI: 10.4168/aair.2011.3.1.46] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 09/28/2010] [Indexed: 11/26/2022]
Abstract
Purpose The objective of this study was to evaluate skills in handling inhalers and factors associated with these skills among patients with asthma who had undergone treatment at special asthma and allergy clinics in Korea. Methods We enrolled 78 subjects who used Turbuhaler and 145 who used Diskus for asthma control at special clinics in 10 university hospitals and visually assessed their skills in handling these inhalers. We also evaluated skills in 137 subjects who had used pressurized metered-dose inhalers (pMDIs) for symptom relief. Age, sex, duration of asthma and inhaler use, smoking status, monthly income, highest grade completed in school and previous instruction for handling inhalers were also measured to evaluate their association with overall inhaler skills. Results Performance grade was inadequate for 12.8% of participants using Turbuhaler, 6.2% for Diskus, and 23.4% for pMDIs. The success rates for each step in handling the inhalers were relatively high except for the "exhale slowly to residual volume" step, in which success rates ranged from 24.2% to 28.5%. Older age, male sex, lower educational grade, and absence of previous instruction for handling inhalers were associated with inadequate inhaler technique in univariate analysis; however, only older age and absence of previous instruction remained significant independent risk factors in multivariate analysis. Conclusions Among Korean asthmatic patients in special asthma and allergy clinics, skills in handling their inhalers were mostly excellent; meanwhile, older age and absence of previous instruction for handling inhalers were associated with inadequate techniques.
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Crompton GK, Barnes PJ, Broeders M, Corrigan C, Corbetta L, Dekhuijzen R, Dubus JC, Magnan A, Massone F, Sanchis J, Viejo JL, Voshaar T. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med 2006; 100:1479-94. [PMID: 16495040 DOI: 10.1016/j.rmed.2006.01.008] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 12/21/2005] [Accepted: 01/09/2006] [Indexed: 11/27/2022]
Abstract
Although the principles of asthma management are well established in Europe, the available data indicate that asthma in patients is not well controlled. Many patients derive incomplete benefit from their inhaled medication because they do not use inhaler devices correctly and this may compromise asthma control. The Aerosol Drug Management Improvement Team (ADMIT), incorporating clinicians from the UK, Germany, France, Italy, Spain and The Netherlands, reviewed published evidence to examine ways to improve the treatment of reversible airways disease in Europe. Data indicate that there is a clear need for specific training of patients in correct inhalation technique for the various devices currently available, and this should be repeated frequently to maintain correct inhalation technique. Devices which provide reassurance to patients and their physicians that inhalation is performed correctly should help to improve patient compliance and asthma control. Educational efforts should also focus on primary prescribers of inhaler devices. ADMIT recommends dissemination of information on the correct inhalation technique for each model of device by the use of an accessible dedicated literature base or website which would enable to match the appropriate inhaler to the individual patient. There is also a need for standardisation of prescribing practices throughout Europe. Regular checking of inhalation technique by prescribers is crucial as correct inhalation is one of the keystones of successful asthma management.
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Affiliation(s)
- G K Crompton
- Respiratory Unit, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, Scotland, UK.
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Préambule. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)85544-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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