Optimizing inhaler use by pharmacist-provided education to community-dwelling elderly

Area of Science:

• Geriatric Medicine
• Pharmaceutical Sciences
• Patient Education

Background:

• Inhaled medications are crucial for managing respiratory conditions in elderly patients.
• Proper administration technique is essential for optimal drug delivery and therapeutic outcomes.
• Patients in Programs for All-inclusive Care for the Elderly (PACE) often require inhaled therapies.

Purpose of the Study:

• To evaluate the effectiveness of pharmacist-led education on inhaled medication administration techniques.
• To assess the ability of elderly PACE participants to demonstrate and maintain proper inhaler use.
• To determine if improved inhaler technique is sustained over time.

Main Methods:

• A six-month observational study was conducted in patients' homes or adult day health centers.
• Participants were individuals in a PACE program using inhaled medications daily.
• A standard observational tool (Hickey's Pharmacies Inhaler Technique assessment) was used to score technique before and after pharmacist instruction.

Main Results:

• Forty-two patients were assessed at baseline, immediately post-education, and 4-6 weeks later.
• Mean inhaler technique scores significantly improved from baseline (14) to initial post-assessment (18) and were sustained at follow-up (17.7).
• Initial training score and auto-refill subscription were strong predictors of sustained improvement, explaining approximately 70% of the variance.

Conclusions:

• Pharmacist education, combined with an auto-refill program, effectively improves and sustains proper inhaler use in community-dwelling elders in PACE programs.
• The observed sustained benefit highlights the long-term value of medication administration education.
• Optimizing inhaler technique ensures appropriate dosing and supports the use of inhaled therapies over oral alternatives.