[Multicenter prospective study of respiratory patient education and instruction in the use of inhalers (EDEN study)]

To evaluate patients' knowledge of the inhalers they use and to assess the effect of knowledge acquired in an instruction session on correct technique.

Multicentric, prospective, descriptive study before and after one instruction session dealing with the technique to apply in using an inhaler: a pressurized canister, an inhalation chamber Autohaler, or one of two dry powder inhalers (the Turbuhaler or the Accuhaler). We studied 349 patients who used their inhalers regularly to treat their respiratory diseases. After assessing their theoretical knowledge of the airways (common), of the particular device they used, and their inhalation technique, we gave instruction in correct technique. Both types of knowledge were then evaluated 2 and 8 months after instruction.

Before instruction, common theoretical knowledge was 3.2 (1) on a 6-point scale and knowledge of the device used was 2.7(1) on a 4-point scale. Technique was assessed as 77 (21) on a 100-point scale. After instruction both theoretical knowledge and technique improved significantly. Common knowledge after instruction was assessed as 5.1 (1) at 2 months and 5.2 (1) at 8 months; knowledge of the inhaler was 3.5 (0.6) and 3.6 (0.7), respectively. Technique was assessed at 95 (11) and 96 (11) at 2 and 8 months, respectively.

The EDEN study demonstrates that knowledge of inhalers in a large sample of the population of respiratory disease patients in Spain, although acceptable, can be improved by an appropriate instruction program. After a standardized instruction program, correct use of all the inhalers studied was achieved. We believe that we thereby contribute to improving symptoms and quality of life of respiratory disease patients.