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Impact
of Patient Education on Inhalation Technique in Obstructive Airways
Disease
Sapna Gore, Parthasarathi G, Mahesh PA*, Sabin Thomas,Satvik BS, Jayaraj VS,
Basavana Gowda H.**
Departments
of Pharmacy Practice, Pulmonology* and Medicine**,JSS Medical College Hospital,
Mysore.
Abstract:
Background:
Asthma
and Chronic Obstructive Pulmonary Disease (COPD) account for a
substantial proportion of ill health in our society. The ideal
treatments include various inhaled medications according to the
standard guidelines on the treatment of obstructive airway diseases.
The major problem with use of inhalers is the inappropriate technique
giving rise to less than optimal improvement while on these drugs. In
certain situations little improvement is seen resulting in the
patients reverting back to oral medications. Patients require
education repeatedly to improve their inhalation technique to obtain
maximal clinical benefit.
Objective:
Our
study was aimed to assess the impact of patient education on the use
of inhaler technique in asthma and COPD patients.
Methods:
Patients
with asthma and COPD were divided into control and test group and
assessed for their inhaler techniques (metered dose inhaler and dry
powder inhaler) at baseline and at each follow up every 15 days for
two months. Test group received additional education about the inhaler
technique by a clinical pharmacist at each visit, while control group
received only one time basic education during first visit about
inhaler technique.
Statistics:
Chi-square
test was used to compare baseline characteristics. For testing the
improvement in repeated patient education, a linear regression was
fitted for both the test and control group. Regression coefficient (b)
was tested by using ‘t’ test.
Results:
Eighty-five
patients were enrolled in the study; fifty-three completed all the
four follow-ups. The most difficult steps in using the metered dose
inhalers were steps 7,8 and 9 and steps 7 and 8 in patient using dry
powder inhalers. A significant improvement in the inhaler technique (p
< 0.05) in the test group was noted with both forms of inhaled
medications as compared to the control group.
Conclusion:
One
time education regarding the inhalation technique may not be
sufficient. Repeated patient education shows better improvement in
inhalation techniques, which is important for improving therapeutic
outcomes.
Effect
of High Dose Inhaled Flucticasone Propionate on Hypothalamo-Pituitary
Adrenal Axis in Patients of Bronchial Asthma
Balakrishnan Menon, Charanjith
Kaur, MPS Menon,Dept.of Respiratory Medicine, V.P.Chest Institute and
VMMC & Safdarjung Hospital, New Delhi.
Abstract:
Inhaled
corticosteroids are currently the mainstay in the management of
asthma. However, the potential for long term adverse effects from
these drugs relates from their systemic absorption. With the
increasing use of Fluticasone propionate (FP) it is important to
establish whether untoward side effects such as hypothalamo-pituitary-adrenal
axis (HPA) suppression takes place when high doses of FP are given.
This study was conducted to evaluate the serum and urinary cortisol
levels of asthmatic patients after treatment with high dose
(1000mg/day) inhaled FP for 6 weeks. In the present study a double
blind crossover design was adopted and HPA axis evaluated by
determining the serum and urinary cortisol levels, which is correlated
with the pulmonary function tests. The conclusion drawn was that FP,
if given at doses of 1000mg through a spacer; is safe and does not
cause any suppression of HPA. Additionally a significant increase in
pulmonary function variables was also recorded
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