title: Use of simulated patient approach to assess the community pharmacists' knowledge of appropriate use of metered dose inhaler.
abstract: BACKGROUND
  The pharmacist charged with the responsibility of drug administration and counseling should have the basic knowledge and skills necessary to demonstrate the use of metered dose inhalers (MDIs) to asthma patients for the maximization of treatment outcomes.
  
  
  OBJECTIVE
  This study was designed to evaluate the community pharmacists' knowledge of the appropriate use of MDIs in Anambra State, Nigeria.
  
  
  METHODS
  The study was carried out in two major cities in Anambra State, Nigeria, using 41 registered community pharmacists. A simulated patient approach utilizing two adequately trained pharmacy students were used. Obtained data were analyzed using independentt-test and one-way ANOVA through SPSS version 18.
  
  
  RESULTS
  The pharmacists had a mean demonstration score of 45.45%. Step number seven of the correct use of MDI, which involves breathing in and depressing the canister was the most demonstrated step (90.2%) while step 4 which involves tilting the head back slightly was the least demonstrated (14.6%) by the pharmacists. Among five identified critical steps in asthma guideline used, two were well demonstrated (75.6% and 90.2%): one averagely demonstrated (51.2%) and two poorly demonstrated (39% and 31.7%). Sociodemographic characteristics did not influence the demonstration ability of the pharmacists in this study.
  
  
  CONCLUSIONS
  The study indicated that community pharmacists lacked the adequate knowledge of appropriate use of MDI. Training programs for pharmacists focusing on the use of such devices will enable them to educate patients on the effective use of MDIs in patients with asthma.
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
authors.forename: Sunday O
authors.initials: SO
authors.lastname: Nduka
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
authors.forename: Maureen U
authors.initials: MU
authors.lastname: Anetoh
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Kosisochi C
authors.initials: KC
authors.lastname: Amorha
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
authors.forename: Okechukwu O
authors.initials: OO
authors.lastname: Henry
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria.
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Okonta
keywords: Asthma; community pharmacist; knowledge; metered dose inhalers