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Effect of verbal counselling on metred-dose inhaler proper use and lung function test amongst asthmatic patients: A
Mona A Abdelrahman1, Haitham Saeed1, Hasnaa Osama1
1Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.
Introduction:
The main cause of poor asthma control is mostly related to the inability of the asthmatic subjects to use their metred-dose inhaler (pMDI) correctly. The present study aimed to evaluate the role of contentious pMDI verbal-counselling on the pMDI inhalation technique and pulmonary functions of asthmatics.
Methods:
Through a systematic literature search up to December 2020, 10 studies with 1937 asthmatic subjects, who had at least two pMDI inhalation technique verbal counselling sessions (visits), were identified reporting relationships between contentious pMDI verbal counselling, and the number of inhalation technique mistakes and lung functions score. Mean difference (MD) with 95% confidence intervals (CIs) was calculated comparing counselling visits results using the continuous method with a random effect model.
Results:
Visit 1 had a significantly higher mean number of mistakes compared with visit 2 (MD, 19.98; 95% CI, 11.54-28.41, P < .001); Also, visit 2 had a significantly higher mean number of mistakes compared with visit 3 (MD, 12.17; 95% CI, 9.31-15.02, P < .001). The extent of improvement in the inhalation technique was higher between visits 1 and 2 compared with that between visits 2 and 3. The impact of continuous verbal counselling was also observed on the forced expiratory volume in one second as percentage of vital capacity [(MD, -5.56; 95% CI, -6.50 to -4.61, P < .001) between visits 1 and 2 and (MD, -6.40; 95% CI, -7.71 to -5.10, P < .001) between visits 2 and 3] and the peak expiratory flow rate [(MD, -11.47; 95% CI, -18.73 to -4.22, P < .001) between visits 1 and 2 and (MD, -16.53; 95% CI, -25.80 to -7.26, P < .001) between visits 2 and 3]. The extent of improvement in lung functions was similar between visits 1 and 2 and visits 2 and 3.
Conclusion:
Based on this meta-analysis, Continuous pMDI verbal counselling, at every possible opportunity, is a must since lung functions and pMDI inhalation technique improvements were observed with continuous pMDI verbal counselling.
Insights
Continuous verbal counseling significantly improves metered-dose inhaler (pMDI) technique and lung function in asthma patients. Regular counseling sessions are crucial for better asthma control and adherence to proper inhaler use.
Area of Science:
- Pulmonary Medicine
- Respiratory Therapy
Background:
- Poor asthma control is frequently linked to incorrect metered-dose inhaler (pMDI) usage.
- Effective patient education on pMDI technique is vital for managing asthma.
Purpose of the Study:
- To assess the impact of continuous verbal counseling on pMDI inhalation technique.
- To evaluate the effect of counseling on pulmonary function in asthma patients.
Main Methods:
- A systematic literature search identified 10 studies with 1937 participants up to December 2020.
- Meta-analysis used a random-effects model to compare outcomes after counseling sessions.
- Key metrics included inhalation technique errors and lung function scores (FEV1%VC, PEFR).
Main Results:
- Significant reductions in inhalation technique errors were observed after each counseling session (p < .001).
- Improvements in forced expiratory volume in one second (FEV1%VC) and peak expiratory flow rate (PEFR) were noted.
- The degree of improvement in inhalation technique was greater between the first and second sessions compared to subsequent sessions.
Conclusions:
- Continuous verbal counseling for pMDI use is essential for improving inhalation technique.
- Consistent counseling positively impacts pulmonary function, contributing to better asthma management.
- Regular reinforcement of pMDI technique should be integrated into asthma care protocols.
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