Phone-Based Teach-To-Goal Inhaler Education Program for Medicare Advantage Beneficiaries With COPD

Individuals with chronic obstructive pulmonary disease (COPD) rely on inhaler-based medications to treat and control symptoms. Most patients do not use correct technique. Teach-to-goal (TTG) inhaler education programs have been found to improve inhaler technique. There is limited understanding as to whether TTG inhaler education is effective when delivered over the phone.

We aimed to find out the effect of a phone-based TTG inhaler technique education program among Medicare Advantage beneficiaries with COPD.

Beneficiaries with a diagnosis of COPD within the prior 2 years, who had filled at least one maintenance inhaler prescription at least once in the prior year, had a value-based insurance design plan, and received the inhaler education component of the COPD intervention program were evaluated. Inhaler technique was measured by validated checklists, and patients self-reported their technique.

Of 1876 patients analyzed, n=13 used more than one inhaler. At the initial assessment, 39.4% of participants were using their inhalers incorrectly. By the end of the first education session, the percentage of participants who were using their inhaler incorrectly decreased to 6.9%.

A phone-based TTG inhaler education program offered by a large national health plan demonstrated improvements in inhaler technique across different inhaler devices and subpopulations. The multiple-session approach was likely critical for longer-term retention of correct technique, though further study is needed to confirm this. Some subgroup populations are also at greater risk for baseline inhaler misuse and/or post-training inhaler misuse indicating a need for further evaluation of how to tailor inhaler education by individuals’ needs.