title: Evaluation of the Prevalence and Effectiveness of Education on Metered-Dose Inhaler Technique.
abstract: BACKGROUND
  The objectives of this study were: (1) to assess the prevalence of and types of education methods provided to participants who use a metered-dose inhaler (MDI), (2) to determine the prevalence of MDI misuse in adults using objective and subjective assessments, and (3) to determine whether any associations exist between the education method and the participant's ability to properly use an MDI.
  
  
  METHODS
  Adult participants who had a current or previous history of MDI use were recruited from retail pharmacies and physician offices in Laurens County, South Carolina. Exclusion criteria included the use of an MDI spacer, inability to speak/understand English, or current acute respiratory illness. Participants completed a survey regarding inhaler use and previous education, a subjective checklist assessment by demonstrating use of an MDI, and an objective assessment by using the Aerosol Inhalation Monitor (AIM).
  
  
  RESULTS
  Of 100 participants, 25% reported never having received education about inhaler technique, and 94% were found to have insufficient MDI technique. No association between the method of education and successful MDI technique with the AIM was identified (P= .31). Participants were less likely to correctly use the AIM if they missed >3 steps in the subjective assessment. (P= .032).
  
  
  CONCLUSIONS
  Although most participants received inhaler education, inhaler misuse was very common. No associations were found regarding method of education and proper inhaler technique.
authors.affiliation: Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina. kmshealy@presby.edu.
authors.forename: Kayce M
authors.initials: KM
authors.lastname: Shealy
authors.affiliation: Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina.
authors.forename: Victoria C
authors.initials: VC
authors.lastname: Paradiso
authors.affiliation: Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Slimmer
authors.affiliation: Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina.
authors.forename: Darien L
authors.initials: DL
authors.lastname: Campbell
authors.affiliation: Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina.
authors.forename: Tiffaney B
authors.initials: TB
authors.lastname: Threatt
mesh_terms: D000328:Adult; D057189:Checklist; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000523:psychology / Q000706:statistics & numerical data*; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D015995:Prevalence; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000523:psychology; D013022:South Carolina; D011795:Surveys and Questionnaires
keywords: MDI education; MDI technique; Vitalograph AIM; metered-dose inhaler (MDI); misuse; objective assessment