title: Inhaler technique training and health-care professionals: effective long-term solution for a current problem.
abstract: BACKGROUND
  The aims of this study were (1) to assess the ability of a range of health-care professionals (HCPs: specialists [physicians specializing in management of airways disease], general practitioners, pharmacists, pharmacist assistants, nurses, and respiratory therapists) in Jordan to demonstrate the correct use of some commonly used inhalers using standardized checklists, with highest scores indicating optimal use, and (2) to evaluate the short-term and long-term effectiveness of a single educational intervention on the HCPs' skills in using inhalers.
  
  
  METHODS
  HCPs' inhaler technique was assessed at baseline. All HCPs were then invited to attend a workshop on asthma management with particular reference to inhaler use. At the workshop, HCP skills in inhaler technique were optimized. Inhaler technique was assessed before and after training. All participants were assessed on their inhaler technique at follow-up (after 4 months).
  
  
  RESULTS
  Two hundred HCPs (10 specialists, 46 general practitioners, 79 pharmacists, 15 pharmacist assistants, 40 nurses, and 10 respiratory therapists) participated in the study. Specialists scored highest on baseline inhaler technique demonstration skills. All HCPs scored poorly in demonstrating the correct use of the dry powder inhalers when compared with pressurized metered-dose inhalers (MDIs) (range of mean scores ± SD: MDI, 7.24 ± 0.97 to 8.70 ± 0.67; Diskus, 4.83 ± 0.51 to 6.30 ± 1.7; Turbuhaler, 4.90 ± 0.32 to 6.40 ± 1.7). Participants attending the workshop showed improved inhaler skills (mean scores before and after training: MDI, 4.77 ± 1.60 vs 8.77 ± 0.52; Diskus, 4.40 ± 2.60 vs 8.85 ± 0.41; Turbuhaler, 4.96 ± 2.05 vs 8.63 ± 0.67). Four months after the workshop, the inhaler technique of 129 participants was again assessed. Those who had attended the workshop (n = 48) scored significantly higher mean scores for all devices (score = 7.64) than nonattendees (n = 81, score = 5.99, P < .001), by one-way analysis of covariance.
  
  
  CONCLUSIONS
  With the exception of specialists, HCPs in Jordan need to be updated on their inhaler technique skills, specifically the newer dry powder inhalers. A single effective educational workshop on inhaler technique can significantly improve HCPs' long-term ability to demonstrate these skills.
authors: Department of Clinical Pharmacy and Therapeutics, Applied Science University, Amman, Jordan dr_iman@asu.edu.jo.
authors: Iman A
authors: IA
authors: Basheti
authors: Department of Clinical Pharmacy and Therapeutics, Applied Science University, Amman, Jordan.
authors: Eyad A
authors: EA
authors: Qunaibi
authors: Department of Pharmacology and Biomedical Sciences, Petra University, Petra, Jordan.
authors: Salim A
authors: SA
authors: Hamadi
authors: Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.
authors: Helen K
authors: HK
authors: Reddel
mesh_terms: D004501:Education, Medical / Q000379:methods*; D004867:Equipment Design; D006282:Health Personnel / Q000193:education*; D006801:Humans; D036501:Metered Dose Inhalers; D011361:Professional Competence; D013997:Time Factors
keywords: Jordan; asthma; education; health-care professionals; inhaler technique; train the trainer