Citation Information :
Dalal S, Shamaliya K, Patni A. Assessment of Inhalational Techniques and Their Common Errors in Bronchial Asthma Patients Coming to Tertiary Hospital of South Gujarat. Indian J Respir Care 2020; 9 (2):204-208.
Objective: The objective was to assess the inhalational techniques and its common errors in bronchial asthma patients.
Methodology: This cross-sectional study was conducted from July 2019 to September 2019. All known asthmatic patients on inhaler therapy attending the Respiratory medicine outpatient department and who met the inclusion criteria were enrolled in the study. All participants were assessed using a pre-designed questionnaire and a standard checklist that was filled using the interview-based method. Data were entered into MS Excel 2010 and analyzed using Epi Info 7.0 and SPSS 16.0. Appropriate frequencies, percentages, and proportions were calculated, and necessary statistical tests were applied.
Results: Of 113 participants, 72 (63.71%) were women and 41 (36.28%) were men. Moreover, 92 patients (81.41%) used dry powder inhalers (DPIs) and 26 patients (23%) used metered-dose inhalers (MDIs). Among these, 73 (64.60%) patients showed incorrect technique in which 57 (50.44%) patients were on DPI and 16 (14.15%) patients on MDI. Among 54 (47.78%) patients with poor clinical control, 46 (40.70%) patients with incorrect technique had partially controlled or uncontrolled asthma.
Conclusion: Despite the availability of proper guidelines, incorrect inhaler technique remains the main causative factor for poor asthma control and compliance.
World Health Organization. WHO GINA Report. Global Strategy for Asthma Management and Prevention, Updated 2018. World Health Organization; 2018.
Al-Jahdali H, Ahmed A, Al-Harbi A, Khan M, Baharoon S, Bin Salih S, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma Clin Immunol 2013;9:8.
Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011;105:930-8.
Hesselink AE, Penninx BW, Wijnhoven HA, Kriegsman DM, van Eijk JT. Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scand. J. Prim Health Care 2001;19:255-60.
Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur Respir J 2002;19:246-51.
Lindgren S, Bake B, Larsson S. Clinical consequences of inadequate inhalation technique in asthma therapy. Eur J Respir Dis 1987;70:93-8.
Ganguly A, Das AK, Roy A, Adhikari A, Banerjee J, Sen S. Study of proper use of inhalational devices by bronchial asthma or COPD patients attending a tertiary care hospital. J Clin Diagn Res 2014;8:HC04-7.
Janaina BM, Carlos RP, Irma G. Inhaled medication for asthma management: Evaluation of how asthma patients, medical students, and doctors use the different devices teach. J Pneumol 2003;29:75-81.
Kebede B, Mamo G, Molla A. Association of asthma control and metered-dose inhaler use technique among adult asthmatic patients attending outpatient clinic, in resource-limited country: A prospective study. Can Respir J 2019;2019:6934040.
Onyedum C, Desalu O, Nwosu N, Chukwuka C, Ukwaja K, Ezeudo C. Evaluation of inhaler techniques among asthma patients seen in Nigeria: An observational cross sectional study. Ann Med Health Sci Res 2014;4:67-73.
Al-Wasil MA, Al-Mohaimeed A. Assessment of inhalation technique in primary care asthmatic patients using metered-dose inhalers with or without a spacer. Ann Saudi Med 2003;23:264-9.
Farooq MZ, Waqar W, Mustaqeem M, Khan JA, Saadullah S. Assessment of inhalation technique among patients of chronic respiratory disorders in Civil Hospital Karachi: A cross sectional study. J Pak Med Assoc 2016;66:1502.
Khurana AK, Dubey K, Goyal A, Pawar KS, Phulwaria C, Pakhare A. Correcting inhaler technique decreases severity of obstruction and improves quality of life among patients with obstructive airway disease. J Family Med Prim Care 2019;8:246-50.
Ayinampudi BK, Gannepalli A, Pacha VB, Kumar JV, Khaled S, Naveed MA. Association between oral manifestations and inhaler use in asthmatic and chronic obstructive pulmonary disease patients. J NTR Univ Health Sci 2016;5:17-23.
