Inhaler Technique and Self-reported Adherence to Medications Among Hospitalised People with Asthma and COPD
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ORIGINAL RESEARCH ARTICLE
Inhaler Technique and Self‑reported Adherence to Medications Among Hospitalised People with Asthma and COPD Astrid Elander1 · Maria Gustafsson1 Published online: 14 October 2020 © The Author(s) 2020
Abstract Background Metered dose inhalers (MDIs) and dry powder inhalers (DPIs) are devices used for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Inhaler technique is important since incorrect technique can lead to a poorer prognosis and hospitalization. Objective The objective of this study was to investigate the inhaler technique and overall adherence to medications in an adult population with asthma and COPD. Patients and Methods Those invited to participate were people admitted to Umeå University Hospital in northern Sweden in October, November and December 2018, with inhaled medication prescribed prior to admission. Inhaler technique was assessed using checklists and observations with placebo-inhalers were conducted. The Medication Adherence Report Scale (MARS)-5 was used to measure self-reported overall adherence to drug medication. Results Of the 23 people included in the study, 26.1% had one or more critical errors in inhaler technique and 30.4% were considered overall non-adherent to drug medication. Among the 23 participants, the mean age, and the number of regularly prescribed medications were higher among those with poor inhaler technique than among people with no error in their inhaler technique. Conclusion This study indicates that poor inhaler technique and overall non-adherence to medications occur among hospitalised people with asthma and COPD living in northern Sweden. Interventions to improve inhaler technique and adherence to drugs are needed. Key Points Incorrect inhaler technique among people with asthma and COPD has been a problem for many years, and it does not seem to have been resolved. There are currently a variety of medication inhaler devices with different critical steps involved. This might be confusing for the users, and requires knowledge and skills among the medical professionals who will teach inhaler techniques to the users.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40801-020-00210-x) contains supplementary material, which is available to authorized users. * Maria Gustafsson [email protected] 1
Department of Integrative Medical Biology, Umeå University, 90187 Umeå, Sweden
1 Introduction Asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory diseases that affect the airways. Asthma is common in all age groups while COPD is more common in older people [1, 2]. The prevalence of asthma varies between different age groups, but according to WHO, 339.4 million people worldwide were affected by asthma in 2016, corresponding to a prevalence of about 4.6% [1]. According to one meta-analysis, the global prevalence of COPD is 11.7% [3]. In Sweden, the reported prevalence of asthma and COPD among adults is estimated to 10% and 8.5%, respective
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