title: Inhaler device technique can be improved in older adults through tailored education: findings from a randomised controlled trial.
abstract: OBJECTIVE
  To investigate the effects of inhaler device technique education on improving inhaler technique in older people with asthma.
  
  
  METHODS
  In a randomised controlled trial, device technique education was provided to a sample of 123 adults aged >55 years who had a doctor diagnosis of asthma. The active education group received one-on-one technique coaching, including observation, verbal instruction and physical demonstration at baseline. The passive group received a device-specific instruction pamphlet only. Inhaler technique, including the critical steps for each device type, was assessed and scored according to Australian National Asthma Council (NAC) guidelines. Device technique was scored objectively at baseline and again at 3 and 12 months post education.
  
  
  RESULTS
  The majority of participants demonstrated poor technique at baseline. Only 11 (21%) of the active intervention group and 7 (16%) of the passive group demonstrated 100% correct technique. By 3 months 26 (48%) of the active group achieved adequate technique. Improvement in technique was observed in the active group at 3 months (P<0.001) and remained significant at 12 months (P<0.001). No statistically significant improvement was observed in the passive group.
  
  
  CONCLUSIONS
  The provision of active device technique education improves device technique in older adults. Passive education alone fails to achieve any improvement in device technique.
authors.affiliation: School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Crane
authors.affiliation: Airways Group, Woolcock Institute of Medical Research, Glebe, NSW, Australia.
authors.forename: Christine R
authors.initials: CR
authors.lastname: Jenkins
authors.affiliation: CRC for Asthma and Airways, Royal District Nursing Service, RDNS Institute, St Kilda, VIC, Australia.
authors.forename: Dianne P
authors.initials: DP
authors.lastname: Goeman
authors.affiliation: Department of Immunology and Allergy, Royal Melbourne Hospital and the University of Melbourne, Parkville, VIC, Australia.
authors.forename: Jo A
authors.initials: JA
authors.lastname: Douglass
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010353:Patient Education as Topic; D016037:Single-Blind Method
chemical_list: D001993:Bronchodilator Agents