title: Telephonic monitoring and optimization of inhaler technique.
abstract: BACKGROUND
  Improper inhaler technique is a common problem affecting asthma control and healthcare costs. Telephonic asthma management can increase access to care while reducing costs and hospitalizations. However, no reliable method has been established for telephonically evaluating and correcting inhaler technique.
  
  
  OBJECTIVE
  The purpose of this study was to pilot test a method for assessing and correcting patient inhaler technique via telephone.
  
  
  METHODS
  Participants (n=30) were adults with asthma using metered-dose inhalers (MDIs) and diskus inhalers. A pharmacist was located in one room and communicated via telephone with a participant in another room. The pharmacist telephonically assessed and taught inhaler technique. Participants were video-recorded, and videos were later examined by a second pharmacist to visually evaluate inhaler technique. Participants were assigned pre- and posteducation inhaler technique scores for the telephonic and video assessments. Scores were based on summated scales for MDI (0-9) and diskus (0-11) inhalers. Paired samples t-tests were used to compare telephone and video assessments.
  
  
  RESULTS
  Findings indicated a significant difference between the telephone and video assessments of MDI technique (p<0.05); however, no difference was found for the diskus inhaler. Comparing pre- and posteducation inhaler technique for MDI and diskus, mean scores significantly improved from 5.7 to 7.8 (p<0.05) and from 8.5 to 10.4 (p<0.05), respectively.
  
  
  CONCLUSIONS
  The telephonic method was able to improve and detect some deficiencies in patients' inhaler technique. However, modifications and further investigation will more clearly determine the role and value of such a telephonic intervention.
authors.affiliation: Clinical Pharmacy, Marshfield Clinic, Marshfield, Wisconsin 54449, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Nelson
authors.forename: Henry N
authors.initials: HN
authors.lastname: Young
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Knobloch
authors.forename: Sara A
authors.initials: SA
authors.lastname: Griesbach
mesh_terms: D000293:Adolescent; D000328:Adult; D003157:Community Pharmacy Services / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D012959:Socioeconomic Factors; D013689:Telephone; D055815:Young Adult