[Usefulness of teaching how to manage the pressurized canister and the Turbuhaler system in hospitalized patients].
OBJECTIVE
[corrected] To assess knowledge of how to use a pressurized canister (PC) or Turbuhaler (TB) systems and to evaluate the usefulness of giving technical instruction to hospitalized patients, analyzing chronic obstructive pulmonary disease (COPD) patients according to degree of obstruction.


METHODS
We evaluated the use of the PC by 107 consecutive patients and the TB by 79 patients upon their admission to the respiratory medicine ward, with reference to the guidelines of the Spanish Society of Respiratory Medicine and Thoracic Surgery. We then evaluated the usefulness of instruction PC or TB technique. We recorded age, sex, underlying respiratory disease, the patient's opinion and time in years the patient had been using the inhaler, FEV1, and technique upon admission and after instruction during the hospital stay.


RESULTS
Only 19% of the patients used the PC and 32% of the TB patients used their inhaler correctly at first. After instruction, the rates of correct use improved to 42% and 70% for the PC and TB, respectively, over the course of an approximately 4-day hospital stay. Among the PC users, 77% believed they were performing the maneuver correctly. All steps for both inhalers improved, as the number of errors decreased, particularly errors considered most relevant (coordination of the trigger and inspiration from the PC or full expiration and breath holding with both systems). The number of correct techniques at the end of the study was similar for all levels of COPD obstruction, and particularly for those using the TB.


CONCLUSIONS
Most patients admitted to our ward were unable to use either inhaler correctly, with incorrect use of the PC being particularly evident. It is possible to improve performance, however, if we take care to teach patients in short instruction sessions. This is true for all COPD patients, regardless of level of obstruction. Our results demonstrate that a program of instruction during a patient's hospital stay is both feasible and important.
Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain. mip.mharo@htrueta.scs.es
M
M
Haro Estarriol
C
C
Lázaro Castañer
C
C
Marín-Barnuevo
M J
MJ
Andicoberry Martínez
M D
MD
Martínez Puerta
D000280:Administration, Inhalation; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data*; D019370:Observation; D010353:Patient Education as Topic / Q000379:methods*; D011380:Programmed Instructions as Topic / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy; D013663:Teaching / Q000379:methods*