title: [Individualized inhalation instruction using check sheets by a pharmacist in community pharmacy improves inhalation techniques in asthmatic patients].
abstract: BACKGROUND
  Many types of inhaled medications are used for the treatment of asthma; however, inadequate inhalation techniques and poor adherence cause exacerbations of asthma symptoms. It is necessary to therefore provide adequate instruction to acquire correct inhalation techniques. This study aimed to evaluate the usefulness of individualized inhalation instruction in asthmatic outpatients by a community pharmacist for an improvement of the inhalation techniques and asthma control.
  
  
  METHODS
  Twenty-eight asthmatic outpatients who have developed asthma over a long period and received prescriptions from Kumamoto Chuo Hospital from April to August 2008 were instructed by a pharmacist on inhalation techniques at Shimokawa Hamasen Pharmacy. Individual instruction by the pharmacist consisted of a skill-check with inhalers, followed by the use of a checklist of inhalation technique, a self-evaluation checklist, and visual information for the patients. Outcomes were evaluated based on changes in inhalation technique mastery between their first visit and the subsequent visit. Nineteen of the 28 patients who completed the Asthma Control Test (ACT) were also evaluated for asthma control according to changes in their ACT scores.
  
  
  RESULTS
  Twenty patients showed inadequate inhalation techniques. The individualized instruction resulted in significant improvement in the inhalation techniques. Moreover, there were significant improvement in the ACT scores (from 19.1 to 21.4) of 19 patients who received the individualized instruction.
  
  
  CONCLUSIONS
  The individualized instruction to the asthmatic outpatients enables them to improve the inhalation techniques to mend their asthmatic symptoms. We suggest that coordination with hospital and community pharmacy improves therapeutic outcomes in inhaled medication for the asthmatic outpatients.
authors.affiliation: Shimokawa Hamasen Pharmacy. ikura@gpo.kumamoto-u.co.jp
authors.forename: Sakiko
authors.initials: S
authors.lastname: Fukuda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshinaga
authors.forename: Naomi
authors.initials: N
authors.lastname: Hirata
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ishitsuka
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Irikura
authors.forename: Tetsumi
authors.initials: T
authors.lastname: Irie
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kohrogi
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010594:Pharmacies / Q000706:statistics & numerical data*; D013256:Steroids / Q000008:administration & dosage
chemical_list: D013256:Steroids