Authors (including presenting author) :
Chan SY (1), Fong HC(1), Tse KY(1)
Affiliation :
(1) Department of Medicine and Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Patient compliance with inhaler therapy techniques is closely related to the effectiveness of chronic respiratory disease treatment, their quality of life and admission rate. In 2024, an active screening pilot project in assessing in-patient inhaler techniques was conducted in acute medical wards.
Objectives :
1. To identify weaknesses and areas for enhancement in in-patient inhaler techniques
2. To Improve patient’s inhaler compliance through standardized assessment tools and education materials.
Methodology :
Standardized inhaler device assessment forms were adopted from the HAHO Specialty Nursing Practice Guideline, inspiratory flow assessment device: In-check dial and inhaler placebos were adopted for assessing in-patient inhaler techniques. Patients admitted to acute medical wards due to COPD, asthma, and Respiratory Type II failure with inhaler use were randomly recruited to assess their inhaler techniques.
Passing criteria for the initial assessment were: 1) Perform all the critical points suggested by the assessment forms and 2) have a compliance rate of >75%. Inhaler placebos and in-check dial were used for education if needed. A second assessment was arranged for patients who failed the initial assessment.
Result & Outcome :
Results:
From 1st March to 30th June 24. A total of 54 cases were assessed. Number of patients using Pressured Metered Dose Inhalers (pMDI), Soft Mist Inhalers (SMI) and Dry Powder Inhaler (DPI) were 94.4% (n=51), 55.6% (n=30) and 27.8% (n=15) respectively. The initial passing rates for pMDI, SMI, and DPI were 49%, 66.7%, and 40% respectively. After individualized bedside education, their passing rate on the second attempt was 100% with an overall compliance rate >90%. Moreover, 6 patients were screened for having insufficient inspiratory flow and needed to switch inhaler devices from DPI to pMDI.
Conclusion:
There is no routine or active in-patient inhaler techniques screening program in our department. The pilot program suggested that 33.3% -60% of patient inhaler techniques were not satisfactory in the initial assessment. After identifying their weaknesses in inhaler techniques by using standardized assessment forms and inspiratory flow assessment device, it helps physicians to prescribe suitable inhaler devices for patients who have insufficient inspiratory flow. Moreover, by using inhaler placebos, it helps to improve patient’s inhaler technique.
