title: Do Face-to-Face Training and Telephonic Reminder Improve Dry Powder Inhaler Technique in Patients with COPD?
abstract: Introduction. Current modes of instruction on inhaler technique are inadequate. We aimed to evaluate the value of face-to-face training and telephonic reminder (FFTTR) for improving Rotahaler technique in experienced patients with COPD.Materials and Methods. A single group pre-/postinterventional study was conducted at Chitwan Medical College Teaching Hospital, Nepal. We assessed the Rotahaler technique of thirty consecutive patients using Rotahaler device for more than one year. Patients with incorrect technique (n= 20) were instructed and trained by a pharmacist. Telephonic reminder was used to reinstruct patients on the correct technique on weekly basis for two weeks and technique was reassessed after 4 weeks of their first training. Descriptive statistics including Wilcoxon Signed Rank test were applied.Results. The mean age was 66.06 ± 10.6. Of 30 patients, 10 (33.3%) performed Rotahaler technique correctly at baseline and were excluded from FFTTR intervention. FFTTR corrected the technique in 18 (90%) patients and the median (IQR) score increased from 6 (5-6) to 8 (8-8) (p< 0.001). The most incorrect steps were "breathe out gently but not towards the inhaler mouthpiece" (16, 80%) and "hold breath for about 10 seconds" (18, 90%) at baseline which improved after intervention.Conclusion. FFTTR approach markedly improved Rotahaler technique in patients with COPD.
authors.affiliation: Hospital Pharmacy, Chitwan Medical College Teaching Hospital, Chitwan, Nepal.
authors.forename: Ramesh Sharma
authors.identifier: 0000-0002-1617-7885
authors.initials: RS
authors.lastname: Poudel
authors.affiliation: Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal.
authors.forename: Shakti
authors.identifier: 0000-0003-0344-091X
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: Department of Pharmacy, Nobel College of Medical Science, Kathmandu, Nepal.
authors.forename: Pawan
authors.initials: P
authors.lastname: Bhatta
authors.affiliation: Department of Internal Medicine, Chitwan Medical College Teaching Hospital, Chitwan, Nepal.
authors.forename: Rano Mal
authors.initials: RM
authors.lastname: Piryani