Main Article Content

Abstract

Asthma is a common long-term inflammatory disease of the airways of the lungs characterized by episodic reversible airway obstruction, increased bronchial reactivity, and airway inflammation. COPD is a progressive lung disease condition that leads to chronically poor airflow, and if not treated properly, may eventually lead to premature death. Inhaled medication is the cornerstone of the pharmacological treatment of patients with asthma and COPD. Majority of patients with Asthma and COPD do not use their inhalers/ nebulizer correctly, and develop side effects with decreasing quality of life. The present study was conducted to assess the patterns of use of DPI, Pressurized MDI, nebulizer and their combinations in patients with Asthma, COPD or other pulmonary diseases. It was aimed to provide counseling to patients using inhalers and nebulizer regarding its proper use. Over a period of 4 months, 137 questionnaires were filled. Majority of patients (17.5% out of 42.7%) were aged above 60 years and were using nebulizers. Most of the techniques for the use of inhaler were not properly implemented. Before the use of inhaler, majority of the patients (36.8%) inhaled air first; during the use of inhaler, patients (58.5%) instantly pressed the canister of inhaler; and after the use of inhaler, most of the patients (59.1%) did not gargle their mouth with water. Almost all patients (94.1%) found the technique of the use of inhaler/ nebulizer to be easy and a higher number of patients (61.3%) were counseled for the proper use of inhaler/ nebulizer. 62.0% of patients did not develop side effects, where as 26.2% and 11.6% of patients respectively developed oral thrush and salivation of mouth or swollen tongue, after the use of inhaler/ nebulizer. Thus education should be provided by health care providers regarding proper use of devices so as to improve patient quality of life.

Keywords

DPI MDI Nebulizer COPD Asthma

Article Details

How to Cite
Sumaya Fatima, Dr. Mohammed Aleem Uddin Naveed, Afroz Begum, Naseha Fatima, Dr. Radha Krishna. K, & Dr. Fahad Abdullah. (2021). Assessment of patterns of use of Dry powder inhaler (DPI), pressurized Metered dose inhaler (MDI), Nebulizer, DPI with MDI, DPI with Nebulizer, MDI with Nebulizer and the combination of DPI, MDI and Nebulizer, in patients with Asthma, Chronic obstructive . International Journal of Research in Pharmacology & Pharmacotherapeutics, 7(2), 108-115. Retrieved from https://ijrpp.com/ijrpp/article/view/241

References

  1. [1]. Waleed M Sweileh1*, Samah W Al-Jabi2, Sa’ed H Zyoud2 and Ansam F Sawalha1. Bronchial asthma and chronic obstructive pulmonary disease: research activity in Arab countries. Sweileh et al. Multidisciplinary Respiratory Medicine 9, 2014, 38
  2. [2]. Maxine A. Paadakis, Stehen J. McPHEE, Associate editor Michael W. Rabow. Text book of Current Medical Diagnosis and Treatment. 2016
  3. [3]. Donald P. Tashkin, MD,a Gerald L. Klein, MD,b,c Shoshana S. Colman, PhD,d Hany Zayed, PhD,d Warren H. Schonfeld, PhDe. Comparing COPD Treatment: Nebulizer, Metered Dose Inhaler, and Concomitant Therapy The American Journal of Medicine 120, 2007, 435-441
  4. [4]. Halbert R, Natoli J, Gano A, Badamgarav E, Buist A, Mannino DM. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 28, 2006, 523–532.
  5. [5]. Mika J. Ma¨kela¨ a,*, Vibeke Backer b, Morten Hedegaard c, Kjell Larsson d. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. Respiratory Medicine 107, 2013, 1481e1490
  6. [6]. Wijdan H Ramadan1 and Aline T Sarkis2. Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma: An observational comparative study. Chronic Respiratory Disease 14(3), 2017, 309–320 ª The Author(s) 2017
  7. [7]. Lia Jahedi, MSc, Sue R. Downie, PhD, Bandana Saini, PhD, Hak-Kim Chan, PhD, and Sinthia Bosnic-Anticevich, PhD Inhaler Technique in Asthma: How Does It Relate to Patients’ Preferences and Attitudes Toward Their Inhalers? Journal of aerosol medicine and pulmonary drug delivery 30, 2017, Mary Ann Liebert, Inc. 42–52
  8. [8]. Jose O.*, Sunil Daniel, Minu Krishnan. Comparison of clinical efficacy of nebulised salbutamol and salbutamol metered dose inhaler in children with mild or moderate exacerbation of bronchial asthma. International Journal of Contemporary Pediatrics Jose O et al. Int J Contemp Pediatr. 4(3), 2017, 741-744
  9. [9]. Malin Axelsson,1 Linda Ekerljung,2 and Bo Lundbäck2 The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control Hindawi Publishing Corporation Nursing Research and Practice 2015, 139070, 7
  10. [10]. Hesselink AE, Penninx BWJH, Wijnhoven HAH, et al. Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scan J Prim Health Care 19, 2001, 255–60.
  11. [11]. Pedersen S, Frost L, Arnfred T. Errors in inhalation technique and efficiency in inhaler use in asthmatic children. Allergy 41, 1986, 118–24.
  12. [12]. Goren A, Noviski N, Avital A, et al. Assessment of the ability of young children to use a powder inhaler device (Turbuhaler). Pediatr Pulmonol 18, 1994, 77–80.
  13. [13]. Brocklebank D, Wright J, Cates C. Systematic review of clinical effectiveness of pressurised metered dose inhalers versus other hand held inhaler devices for delivering corticosteroids in asthma. BMJ 323, 2001, 1–7.
  14. [14]. Van der Palen J, Klein JJ, van Herwaarden CLA, et al. Multiple inhalers confuse asthma patients. Eur Respir J 14, 1999, 1034–7.
  15. [15]. Franks M, Briggs P. Use of a cognitive ergonomics approach to compare usability of a multidose dry powder inhaler and a capsule dry powder inhaler: an open-label, randomized, controlled study. Clin Ther 26, 2004, 1791–9.
  16. [16]. Van Beerendonk I, Mesters I, Mudde AN, et al. Assessment of the inhalation technique in outpatients with asthma or chronic obstructive pulmonary disease using a metered-dose inhaler or dry powder device. J Asthma. 35, 1998, 273-279.
  17. [17]. Gibson PG, McDonald VM, Marks GB. Asthma in older adults. Lancet 376, 2010, 803e13.
  18. [18]. Newman SP, Busse WW. Evolution of dry powder inhaler design, formulation, and performance. Respir Med 96, 2002, 293–304.
  19. [19]. Federico Lavorinia, Antoine Magnanb,c,d,_, Jean Christophe Dubuse,f, Thomas Voshaarg, Lorenzo Corbettaa, Marielle Broedersh, Richard Dekhuijzenh, Joaquin Sanchisi, Jose L. Viejoj, Peter Barnesk, Chris Corriganl, Mark Levym, Graham K. Cromptonn Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD Respiratory Medicine 102, 2008, 593–604.