title: Diverse Inhaler Devices: A Big Challenge for Health-Care Professionals.
abstract: BACKGROUND
  The current variety of medication inhaler devices can be confusing to patients due to the many different delivery systems. Many health-care professionals who prescribe these devices may not be educated properly about the administration techniques for different inhalers. The objectives of this study were to evaluate various health-care providers' knowledge of specific inhaler devices and to assess their ability to retain this knowledge for a minimum period of 3 months.
  
  
  METHODS
  This was a prospective study that included 4 different health-care professional groups (physicians, respiratory therapists, registered nurses, and pharmacists). All subjects underwent baseline written and practical tests. A checklist was developed for the practicum test for each inhaler on the correct delivery method. The written examination tested knowledge of 4 different inhaler techniques with true or false questions. Then subjects watched an instructional video that demonstrated the correct method of delivery for each device. Last, subjects were retested on the practicum and written tests after a minimum lapse of 3 months.
  
  
  RESULTS
  The distribution of written and practical scores at baseline and postintervention was approximately normal (P > .05). The baseline written scores were significantly different across groups (P = .002). The mean written score of respiratory therapists was significantly higher than those of registered nurses and physicians (P = .02 and .01, respectively). Similarly, the baseline practical scores were significantly different across groups (P < .001). The mean practical score of respiratory therapists was significantly higher compared with those of registered nurses and physicians (P = .002 and P < .001, respectively).
  
  
  CONCLUSIONS
  We found a suboptimal number of medical professionals who have the proper knowledge base and technical skill to teach different inhaler device techniques. In order to increase the simplicity and effectiveness of delivering inhaler medication, we hope that the industry will provide more uniformity for future inhaler devices.
authors.affiliation: Cardiopulmonary Sciences Department, Loma Linda University, Loma Linda, California. aalismail@llu.edu.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alismail
authors.affiliation: Respiratory Care Department.
authors.forename: Cassaundra A
authors.initials: CA
authors.lastname: Song
authors.affiliation: Respiratory Care Department.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Terry
authors.affiliation: School of Allied Health Professions, Loma Linda University, Loma Linda, California.
authors.forename: Noha
authors.initials: N
authors.lastname: Daher
authors.affiliation: Cardiopulmonary Sciences Department, Loma Linda University, Loma Linda, California.
authors.forename: Waleed A
authors.initials: WA
authors.lastname: Almutairi
authors.affiliation: Critical Care Department, Loma Linda Medical Center, Loma Linda, California.
authors.forename: Takkin
authors.initials: T
authors.lastname: Lo
mesh_terms: D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents
keywords: DPI; MDI; education; health-care professionals; inhaler techniques; inhalers; pharmacists; physicians; registered nurses; respiratory therapist