Knowledge of Nurses and Primary Care Physicians on Inhaled Therapy Devices and Techniques

We aimed to assess the knowledge of health care professionals regarding inhaled therapy devices and techniques and to evaluate the effectiveness of a targeted educational intervention.

An educational program designed to update the knowledge and improve the technical skills of these professionals in the use of different types of inhalers was developed. Before and after each training session, we applied an ad hoc questionnaire that consisted of 15 multiple-choice questions on inhaled therapy grouped into three sections, including knowledge about devices used for inhaled therapy, knowledge about inhaler techniques, and knowledge about adherence to inhaled therapy, as well as the Test of the Adherence to Inhalers. The questionnaire also included a summary question. We calculated the mean score and the standard deviation for the pre- and postevaluations, compared the mean scores using Student's t-test, and evaluated the relevance of the changes using Cohen's d.

During the 23 meetings held throughout Spain, 267 participants completed the pretraining questionnaire, including 105 primary care physicians, 90 nurses of specialized care, 41 nurses working in primary care, and 31 health care professionals of various origins. Overall, the mean (SD) total score (i.e., number of correct answers out of a maximum of 15; range 0-15) significantly increased from 8.99 (2.26) to 11.46 (2.50) points, for a mean pre-post difference of 2.5 (p < 0.001). Notable issues included the misidentification of device types and confusion between inhalation techniques for pressurized metered-dose inhalers and dry powder inhalers. The mean total scores significantly increased across the three main specialties, with large effect sizes in all cases.

Our study suggests that both primary care physicians and nurses have relevant gaps in knowledge- and technique-related issues regarding the use of inhalation devices that could be improved using a brief educational intervention.