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Inhaler Competence in Nepalese Patients with Asthma and Chronic Obstructive Pulmunory Disease: A Systematic Review
Ramesh Sharma Poudel1, Shakti Shrestha2, Daniel Asfaw Erku3
1Hospital Pharmacy, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal.
Journal of Nepal Health Research Council
|December 23, 2022
Summary
Incorrect inhaler use is common in Nepalese patients with asthma and COPD. Educational interventions significantly improved inhaler technique, highlighting the need for targeted training programs.
Area of Science:
- Respiratory Medicine
- Public Health
Background:
- Inhaler misuse is a significant global issue for asthma and COPD patients.
- This review focuses on prevalence, contributing factors, and intervention effectiveness in Nepal.
Approach:
- Systematic literature search across major databases (PubMed, Embase, CINAHL, Google Scholar).
- Inclusion of studies on asthma/COPD patients using dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs).
- Quality assessment using NHLBI tools and descriptive narrative synthesis.
Key Points:
- High rates of incorrect inhaler technique (64-100% overall, 9-100% critical errors) observed in Nepalese patients.
- Incorrect use linked to patient, inhaler, and healthcare professional factors.
- Interventions combining verbal, physical, and face-to-face training showed significant improvement (23-37% overall, 7-42% critical steps).
Conclusions:
- Nepalese asthma and COPD patients exhibit substantial errors in DPI and pMDI use.
- Well-designed educational interventions are crucial for improving inhaler technique in this population.
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