J 2019

Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease

VYTRISALOVA, Magda, Tereza HENDRYCHOVA, Tereza TOUSKOVA, Eva ZIMCIKOVA, Jiri VLCEK et. al.

Basic information

Original name

Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease

Authors

VYTRISALOVA, Magda (203 Czech Republic), Tereza HENDRYCHOVA (203 Czech Republic), Tereza TOUSKOVA (203 Czech Republic), Eva ZIMCIKOVA (203 Czech Republic), Jiri VLCEK (203 Czech Republic), Libor NEVORANEK (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Karel HEJDUK (203 Czech Republic, belonging to the institution), Kristián BRAT (703 Slovakia, belonging to the institution), Marek PLUTINSKÝ (703 Slovakia, belonging to the institution), Barbora NOVOTNA (203 Czech Republic), Pavlina MUSILOVA (203 Czech Republic), Matej CERNOHORSKY (203 Czech Republic) and Vladimir KOBLIZEK (203 Czech Republic, guarantor)

Edition

Frontiers in Pharmacology, Lausanne, Frontiers Media SA, 2019, 1663-9812

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 4.225

RIV identification code

RIV/00216224:14110/19:00109448

Organization unit

Faculty of Medicine

UT WoS

000460973800001

Keywords in English

chronic obstructive pulmonary disease; adherence to application technique; inhalation systems; inhalation adherence; five steps assessment; device mastery; inhaler mishandlings

Tags

International impact, Reviewed
Změněno: 15/4/2019 14:02, Soňa Böhmová

Abstract

V originále

Background: Patient adherence to an inhaled medication application technique (A-AppIT) represents a major health-care issue in patients with chronic obstructive pulmonary disease (COPD). However, there is a lack of studies evaluating this issue thoroughly. The aim of our study was to introduce a universal easy-to-use method of assessing the A-AppIT to chronic medication in moderate to very severe COPD individuals. Methods: The Czech Multicenter Research Database of COPD (COPD CMRD), a large observational prospective study, was used as a source of clinical data. A-AppIT was evaluated using our Five Steps Assessment. This measure is based on dichotomous evaluation of each of five predefined consecutive application technique steps and can be used in all settings for all currently available inhalation systems in COPD subjects. Results: A total of 546 participants (75.0% men; mean age 66.7 years; mean forced expiratory volume in 1s 44.7%) were available for analysis. This represents 69.6% of all patients recruited in the COPD CMRD. Less than one third of patients presented their application technique without any erroneous steps. The most problematic steps were breathing out completely in one breath immediately before inhalation (step No. 3), and the actual inhalation maneuver (step No. 4). The total number of errors was similar for dry powder inhalers and pressurized metered-dose inhalers. Conclusion: Our novel instrument, Five Steps Assessment, is comfortable for use in routine clinical practice to explore A-AppIT. The A-AppIT in real-life patients with non-mild COPD was inadequate and patients should be repeatedly trained by properly (re-)educated medical staff.