Understanding the Knowledge Gap and Assessing Comfort Level among Healthcare Professionals Who Provide Inhaler Education

Figures & data

Table 1. Survey questions with correct response rates.

Question number	Correct response rate of question	Associated inhaler device	Correct response rate of inhaler device
1. After removal of the cap, should the inhaler be shaken thoroughly prior to each use? (Yes)	89%	Metered Dose Inhaler (MDI)	55%
2. Does a new device require priming before the first use? (Yes)	69%
3. When using the device, should the inspiration be forceful and deep? (No)	30%
4. When using a MDI with a spacer, which of the following is correct? (Whistling by the spacer indicates poor inhaler technique)	54%
5. How long do you instruct patients to hold their breath after each inhalation? (At least 6 seconds)	38%
6. After Removal of the cap, should the inhaler be shaken thoroughly prior to each use? (No)	69%	Dry Powder Inhaler (DPI)	52%
7. Does a new device require priming before the first use? (No)	46%
8. When using the device, should the inspiration be forceful and deep? (Yes)	63%
9. The inspiratory force required for adequate use of DPI is? (>60 Liters per minute)	28%
10. Which of the following impairs delivery/mobilization of medication with DPI? (Breathing into the device prior to use)	52%
11. After Removal of the cap, should the inhaler be shaken thoroughly prior to each use? (No)	32%	Soft-Mist Inhaler (SMI)	34%
12. Does a new device require priming before the first use? (Yes)	37%
13. When using the device, should the inspiration be forceful and deep? (No)	32%
14. Actuation of the SMI occurs by? (Pushing a Button)	51%
15. With SMI, should the cap be removed before twisting the device in preparation of actuation? (No)	20%

Correct responses to survey questions denoted in parenthesis.

Figure 1. Breakdown of survey respondents.

Table 2. Comparing correct response rates among prescribers versus non-prescribers.

Provider discipline		Correct response rate
Overall		47%
All Prescribers		47%
Prescribers	Pulmonary Fellows (n = 73)	60%
	Internal Medicine Residents (n =101)	40%
	Family Medicine Residents (n = 74)	42%
All Non-Prescribers		47%
Non-Prescribers	Respiratory Therapists (n = 40)	85%
	Pharmacists (n = 14)	71%
	Nursing Staff (n = 255)	40%

Figure 2. Provider comfort compared to correct response rate. Bars indicate correct response rate percentage based on comfort level. R-values indication correlation between Likert score and correct response rate.

• Comfort Assessment Question 1: How would you rate your comfort level in prescribing inhaled medications?

• Comfort Assessment Question 2: How would you rate your comfort level in teaching patients how to use inhaled medications?

• Comfort Assessment Question 3: How would you rate your comfort level in understanding the limitations and differences between the various inhaler devices?

• Comfort Assessment Question 4: How would you rate your comfort level in using an inhaler device?

• Comfort Assessment Question 5: How would you rate your comfort level in recommending the most appropriate inhaler device for various patient populations?

Figure 3. Comparing provider experience to correct response rate.

Table 3. Comparing correct response rates by inhaler device.

Provider discipline		Inhaler device
		MDI	DPI	SMI
Overall		55%	52%	34%
All Prescribers		51%	52%	38%
Prescribers	Pulmonary Fellows	58%	61%	62%
	Internal Medicine Residents	48%	44%	29%
	Family Medicine Residents	49%	52%	26%
All Non-Prescribers		58%	52%	32%
Non-Prescribers	Respiratory Therapists	88%	92%	75%
	Pharmacists	71%	76%	66%
	Nursing Staff	53%	44%	23%

MDI (Meter Dose Inhaler); DPI (Dry Powder Inhaler); SMI (Soft-Mist Inhaler).