Pharmacists’ training to improve inhaler technique of patients with COPD in Vietnam

Abstract

Background

Incorrect use of inhalers is very common and subsequently leads to poor control of COPD. Among health care providers, pharmacists are in the best position to educate patients about the correct use of inhaler devices.

Objective

The objective of this study was to evaluate the impact of pharmacist-led training on the improvement of inhaler technique for COPD patients in Vietnam.

Patients and methods

For this pre- and post-intervention study, standardized checklists of correct use of metered-dose inhalers (MDIs) and dry powder inhalers (DPIs) were used to evaluate the inhaler technique. A scoring system (maximum score =8) was applied before and after training to guarantee assessment uniformity among pharmacists. Three methods including “face-to-face training”, “teach-back” and “technique reminder label” were used. After the baseline evaluation (T0), the inhaler technique was reassessed after 1 month (T1), 3 months (T2), 6 months (T3) and 12 months (T4).

Results

A total of 211 COPD patients participated in the study. Before the training, a high rate of errors was recorded. After the training, the percentage of patients using MDIs and DPIs perfectly increased significantly (p<0.05). The mean technique score for MDIs and DPIs improved from 6.0 (T0) to 7.5 (T3) and 6.9 (T4) and 6.7 (T0) to 7.6 (T3) and 7.2 (T4), respectively (p<0.05). The average training time was 6 minutes (T0) and 3 minutes (T3), respectively.

Conclusion

Pharmacist-led comprehensive inhaler technique intervention program using an unbiased and simple scoring system can significantly improve the inhaler techniques in COPD patients. Our results indicated a 3-month period as the optimal time period between training and retraining for maintaining the correct inhaler technique. The training would be highly feasible and suitable for implementing in the clinical setting. Our model of pharmacist-led training should be considered as an effective solution for managing COPD patients and better utilization of health care human resources, especially in a developing country like Vietnam.

Keywords:

• MDI
• Turbuhaler^®
• teaching and scoring methods
• technique score
• technique reminder label

Acknowledgments

The authors would like to thank patients for participating in the study and pharmacists of the Department of Pharmacy, Bach Mai Hospital, for training patients, especially Mrs Nguyen Hoai Thu, Miss Do Thi Thu Hien and Miss Kim Huyen Trang. The authors also wish to thank the Board of Directors of Bach Mai Hospital and members of Department of Clinical Pharmacy, Hanoi University of Pharmacy, for supporting the study.

Author contributions

All authors contributed to tool development and study design, data analysis, drafting and revising the manuscript, gave final approval of the manuscript version to be published, and agreed to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Notes

Abbreviation: MDI, metered-dose inhaler.