title: Study of Proper use of Inhalational Devices by Bronchial Asthma or COPD Patients Attending a Tertiary Care Hospital.
abstract: OBJECTIVE
  To examine the frequency of proper use of inhalation devices and influence of age and training on it.
  
  
  METHODS
  One hundred and five subjects of bronchial asthma and Chronic Obstructive Pulmonary Disease (COPD); aged between 18 to 75 y (mean ± SD; 46 ± 28.55) were studied. Subjects were enrolled over a period of three months. Data like weight, height and concomitant medications were recorded. It was an observational and questionnaire based study. Parameters were chosen to demonstrate the inhalational technique, errors committed in different steps of use & nature of medical, paramedical, nursing personals and others imparting training for use of inhaler device and time devoted for it.
  
  
  RESULTS
  Of total 105 patients, 31 were using dry powdered inhalers (DPI), 50 on metered dose inhalers (MDI), and 24 on MDI with spacer devices. Among study population 83.81% were trained by healthcare professionals (doctors, nurse, pharmacists, paramedical or representatives of Pharmaceutical companies) and 16.19% are trained by general people. Among the MDI users (n=50) only 6%, 16.12% among the DPI users, 20.8%, among MDI with spacer users could use inhalers correctly. At 95% confidence limit there was significance of errors committed between DPI and MDI users (difference of SE is 2.56) and between spacer and MDI users (difference of SE 2.92). There was no difference found in regard of frequency of errors committed in taking different devices according to patient's socioeconomic, educational background and trainer.
  
  
  CONCLUSIONS
  It was concluded that use of MDI with spacer most convenient method. Doctors often did not have sufficient time to train patients regarding proper technique of inhaler use. With ever increasing and widespread use of inhalers patients' education is becoming more important. Proper training will surely make these drugs more effective and cost benefit ratio more favourable.
authors.affiliation: Assistant Professor, Department of Pharmacology, R. G. Kar Medical College & Hospital , Kolkata, India .
authors.forename: Avijit
authors.initials: A
authors.lastname: Ganguly
authors.affiliation: Professor and Head, Department of Pharmacology, R. G. Kar Medical College & Hospital , Kolkata, India .
authors.forename: Anup Kumar
authors.initials: AK
authors.lastname: Das
authors.affiliation: Assistant Professor, Department of Physiology, R. G. Kar Medical College & Hospital , Kolkata, India .
authors.forename: Anindya
authors.initials: A
authors.lastname: Roy
authors.affiliation: Associate Professor, Department of Pharmacology, R. G. Kar Medical College & Hospital , Kolkata, India .
authors.forename: Anjan
authors.initials: A
authors.lastname: Adhikari
authors.affiliation: Assistant Professor, Department of Physiology, R. G. Kar Medical College & Hospital , Kolkata, India .
authors.forename: Joyashree
authors.initials: J
authors.lastname: Banerjee
authors.affiliation: Postgraduate Trainee, Department of Physiology, R. G. Kar Medical College & Hospital , Kolkata, India .
authors.forename: Sumitra
authors.initials: S
authors.lastname: Sen
keywords: Bronchial asthma; COPD; Inhaler; Spacer device