title: Problems of elderly patients on inhalation therapy: Difference in problem recognition between patients and medical professionals.
abstract: BACKGROUND
  There is no systematic analysis to identify problems involved with instruction on inhalation therapy for elderly patients. We conducted a nationwide questionnaire survey for patients and medical professionals.
  
  
  METHODS
  A questionnaire survey was conducted of adult patients on inhaled drugs (ages 18-92 years, 820 individuals) and medical professionals (pharmacists or nurses) who provided instruction on inhalation therapy to these patients in 23 institutions in Japan to investigate the technique and the level of understanding (knowledge) of the inhalation therapy. Changes in the recognition of performance of inhalation technique and inhalation knowledge with increasing age were analyzed.
  
  
  RESULTS
  According to patients' subjective assessment, there was no deterioration in the performance of the inhalation technique or loss of the knowledge with increasing age. On the other hand, medical professionals' objective assessment revealed a significant loss of both inhalation technique and knowledge with increasing age. Not many elderly patients noticed their own problems themselves, revealing a great perception gap between elderly patients and medical professionals. Thus, there was concern that patients would unconsciously practice the inhalation procedure improperly. On the other hand, in comparison with non-elderly patients, elderly patients were less resistant to continuation of therapy, suggesting that they would be more likely to accept instruction on inhalation therapy.
  
  
  CONCLUSIONS
  Elderly patients are apt to assume that they "understand well", therefore, in order to recognize and close the perception gap between elderly patients and medical professionals, it is necessary to provide them with more aggressive (frequent) instructions on inhalation therapy.
authors.affiliation: Department of Pharmacy, Shiga University of Medical Science Hospital, Shiga, Japan. Electronic address: hirad@belle.shiga-med.ac.jp.
authors.forename: Daiki
authors.initials: D
authors.lastname: Hira
authors.affiliation: Department of Respiratory Internal Medicine, St. Marianna University, School of Medicine, Yokohama-City Seibu Hospital, Kanagawa, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Komase
authors.affiliation: Kinki-Chozai Kadono Sanjo Pharmacy, Kyoto, Japan.
authors.forename: Setsuko
authors.initials: S
authors.lastname: Koshiyama
authors.affiliation: National Hospital Organization Higashi-Ohmi General Medical Center, Shiga, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Oguma
authors.affiliation: Hiramatsu Clinic, Aichi, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hiramatsu
authors.affiliation: Department of Respiratory Medicine, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Shiraki
authors.affiliation: Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishikawa
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakanishi
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: Ichimura Clinic, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ichimura
authors.affiliation: Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kinki University, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwanaga
authors.affiliation: Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Morikawa
authors.affiliation: Department of Airway Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Yasuba
authors.affiliation: Department of Respiratory Medicine, Teine Keijinkai Hospital, Hokkaido, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Sugaya
authors.affiliation: Sleep and Respiratory Disease Center, KKR Takamatsu Hospital, Kagawa, Japan.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Arakawa
authors.affiliation: Department of Otolaryngology, Kansai Medical University, Osaka, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital, Aichi, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kato
authors.affiliation: Kagawa Pharmaceutical Association, Kagawa, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Futamura
authors.affiliation: Suita Municipal Hospital, Osaka, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Tsuji
authors.affiliation: Department of Pharmacy, Shiga University of Medical Science Hospital, Shiga, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Terada
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010361:Patients / Q000706:statistics & numerical data; D011159:Population Surveillance; D012372:ROC Curve; D012138:Respiratory Therapy / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Asthma therapy; Elderly patient; Inhalation instruction; Inhalation medicine; Nationwide questionnaire survey