Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics

Abstract Background Pressurized metered-dose inhalers (pMDIs) are among the most common devices that asthmatic patients use. The poor pMDI inhalation technique mostly results in poor lung deposition. The present work aimed to compare the impact of introducing two different training devices combined...

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Main Authors: Ahmed H. M. Sobh, Hoda Rabea, Manal Ali Hamouda, Farid Shawky, Mohamed E. A. Abdelrahim
Format: Article
Language:English
Published: SpringerOpen 2022-07-01
Series:Beni-Suef University Journal of Basic and Applied Sciences
Subjects:
Online Access:https://doi.org/10.1186/s43088-022-00268-2
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author Ahmed H. M. Sobh
Hoda Rabea
Manal Ali Hamouda
Farid Shawky
Mohamed E. A. Abdelrahim
author_facet Ahmed H. M. Sobh
Hoda Rabea
Manal Ali Hamouda
Farid Shawky
Mohamed E. A. Abdelrahim
author_sort Ahmed H. M. Sobh
collection DOAJ
description Abstract Background Pressurized metered-dose inhalers (pMDIs) are among the most common devices that asthmatic patients use. The poor pMDI inhalation technique mostly results in poor lung deposition. The present work aimed to compare the impact of introducing two different training devices combined with their related smartphone applications on the proper performance of the inhalation technique and lung function in asthmatic adults. Methods A total of 316 patients were allocated to 3 groups, 105 in the control group (normal patient education group), 104 in the group using the Clip-Tone device and its smartphone applications, and 107 in the group using the Flo-Tone and its smartphone applications. Each group had three visits. Their number of inhalation technique mistakes was recorded, their forced expiratory volume in the first second (FEV1) was measured, and an asthma control test (ACT) was given. Afterward, they had their allocated training. Differences in medians of outcomes among repeated visits per group and different groups per visit were measured. Finally, correlation statistics between FEV1% of predicted and the correct performance of inhalation technique (as a whole and as separate steps) per visit were conducted to study any associations if existed. Results In the short term (after 2 visits), the Clip-Tone group showed significant superiority (p < 0.01) to both, the control and Flo-Tone groups, in terms of overall proper technique performance, and FEV1% of predicted. In the long term (after 3 visits), both interventions have shown significant superiority to the control in terms of correct inhalation technique performance (p < 0.05) and FEV1% of predicted (p < 0.01). None of them have shown significant superiority to each other. In terms of ACT scores, the Flo-Tone group showed significant improvement to both the control (p < 0.01) and the Clip-Tone (p < 0.05) groups in the second visit. In the third visit, both advancement counseling groups showed significant superiority to the control group (p < 0.01); However, the difference in medians between both Clip-Tone’s and Flo-Tone’s ACT scores disappeared. Weak, yet significant (− 0.146, p < 0.05) negative correlation existed between the number of mistakes in inhalation technique in the third visit and FEV1% of predicted. Correct performance of step 7 in the third visit showed a weak significant positive correlation (0.2, p < 0.01) with FEV1% of predicted. Conclusion Introducing new training devices to the normal counseling that provides visual and audial feedback has shown that they could further enhance the inhalation technique performance and subsequently the lung function outcomes and asthma control of asthmatic patients. Yet, larger studies might be required to test the superiority of one to another.
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spelling doaj.art-9ebdb85712b94bea97b73928f985cf122022-12-22T01:20:47ZengSpringerOpenBeni-Suef University Journal of Basic and Applied Sciences2314-85432022-07-011111910.1186/s43088-022-00268-2Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmaticsAhmed H. M. Sobh0Hoda Rabea1Manal Ali Hamouda2Farid Shawky3Mohamed E. A. Abdelrahim4Clinical Pharmacy Department, Faculty of Pharmacy, Ahram Canadian UniversityClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef UniversityFaculty of Pharmacy, Menufeya UniversityDepartment of Chest Diseases, Faculty of Medicine, Al Azhar UniversityClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef UniversityAbstract Background Pressurized metered-dose inhalers (pMDIs) are among the most common devices that asthmatic patients use. The poor pMDI inhalation technique mostly results in poor lung deposition. The present work aimed to compare the impact of introducing two different training devices combined with their related smartphone applications on the proper performance of the inhalation technique and lung function in asthmatic adults. Methods A total of 316 patients were allocated to 3 groups, 105 in the control group (normal patient education group), 104 in the group using the Clip-Tone device and its smartphone applications, and 107 in the group using the Flo-Tone and its smartphone applications. Each group had three visits. Their number of inhalation technique mistakes was recorded, their forced expiratory volume in the first second (FEV1) was measured, and an asthma control test (ACT) was given. Afterward, they had their allocated training. Differences in medians of outcomes among repeated visits per group and different groups per visit were measured. Finally, correlation statistics between FEV1% of predicted and the correct performance of inhalation technique (as a whole and as separate steps) per visit were conducted to study any associations if existed. Results In the short term (after 2 visits), the Clip-Tone group showed significant superiority (p < 0.01) to both, the control and Flo-Tone groups, in terms of overall proper technique performance, and FEV1% of predicted. In the long term (after 3 visits), both interventions have shown significant superiority to the control in terms of correct inhalation technique performance (p < 0.05) and FEV1% of predicted (p < 0.01). None of them have shown significant superiority to each other. In terms of ACT scores, the Flo-Tone group showed significant improvement to both the control (p < 0.01) and the Clip-Tone (p < 0.05) groups in the second visit. In the third visit, both advancement counseling groups showed significant superiority to the control group (p < 0.01); However, the difference in medians between both Clip-Tone’s and Flo-Tone’s ACT scores disappeared. Weak, yet significant (− 0.146, p < 0.05) negative correlation existed between the number of mistakes in inhalation technique in the third visit and FEV1% of predicted. Correct performance of step 7 in the third visit showed a weak significant positive correlation (0.2, p < 0.01) with FEV1% of predicted. Conclusion Introducing new training devices to the normal counseling that provides visual and audial feedback has shown that they could further enhance the inhalation technique performance and subsequently the lung function outcomes and asthma control of asthmatic patients. Yet, larger studies might be required to test the superiority of one to another.https://doi.org/10.1186/s43088-022-00268-2AsthmaPatient educationClip-ToneFlo-ToneInhalation techniqueLung function
spellingShingle Ahmed H. M. Sobh
Hoda Rabea
Manal Ali Hamouda
Farid Shawky
Mohamed E. A. Abdelrahim
Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
Beni-Suef University Journal of Basic and Applied Sciences
Asthma
Patient education
Clip-Tone
Flo-Tone
Inhalation technique
Lung function
title Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
title_full Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
title_fullStr Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
title_full_unstemmed Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
title_short Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
title_sort impact of repeated patient counseling using different pressurized metered dose inhalers training devices on inhalation technique lung function and asthma control in adult asthmatics
topic Asthma
Patient education
Clip-Tone
Flo-Tone
Inhalation technique
Lung function
url https://doi.org/10.1186/s43088-022-00268-2
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