title: Effectiveness of Various Methods of Teaching Proper Inhaler Technique.
abstract: OBJECTIVE
  To compare the effectiveness of 4 different instructional interventions in training proper inhaler technique.
  
  
  METHODS
  Randomized, noncrossover trial.
  
  
  METHODS
  Health fair and indigent clinic.
  
  
  METHODS
  Inhaler-naive adult volunteers who spoke and read English.
  
  
  METHODS
  Subjects were assigned to complete the following: (1) read a metered dose inhaler (MDI) package insert pamphlet, (2) watch a Centers for Disease Control and Prevention (CDC) video demonstrating MDI technique, (3) watch a YouTube video demonstrating MDI technique, or (4) receive direct instruction of MDI technique from a pharmacist.
  
  
  METHODS
  Inhaler use competency (completion of all 7 prespecified critical steps).
  
  
  RESULTS
  Of the 72 subjects, 21 (29.2%) demonstrated competent inhaler technique. A statistically significant difference between pharmacist direct instruction and the remaining interventions, both combined ( P < .0001) and individually ( P ≤ .03), was evident. No statistically significant difference was detected among the remaining 3 intervention groups. Critical steps most frequently omitted or improperly performed were exhaling before inhalation and holding of breath after inhalation.
  
  
  CONCLUSIONS
  A 2-minute pharmacist counseling session is more effective than other interventions in successfully educating patients on proper inhaler technique. Pharmacists can play a pivotal role in reducing the implications of improper inhaler use.
authors.affiliation: 1 Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Axtell
authors.affiliation: 1 Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA.
authors.forename: Seena
authors.initials: S
authors.lastname: Haines
authors.affiliation: 1 Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Fairclough
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy; D018592:Cross-Over Studies; D004348:Drug Labeling / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000592:standards / Q000706:statistics & numerical data*; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D010595:Pharmacists / Q000592:standards; D024382:Professional Role; D011446:Prospective Studies; D016896:Treatment Outcome; D014741:Video Recording / Q000379:methods* / Q000592:standards; D055815:Young Adult
keywords: COPD; asthma; inhaler technique; patient education; pharmacist counseling