Effectiveness of Various Methods of Teaching Proper Inhaler Technique: The Importance of Pharmacist Counseling

This article delves into the role of a pharmacist in patient inhaler education.  There were four different interventions that were compared in this study. The purpose of the study was to determine the efficacy of direct patient education vs. video or print education.

  1. Patient reads a metered dose inhaler (MDI) package insert pamphlet.
  2. Patient watches a Centers for Disease Control and Prevention (CDC) video demonstrating MDI technique.
  3. Patient watches a YouTube video demonstrating MDI technique
  4. Pharmacist gives patient direct instruction of MDI technique (2 minutes long)

This study had a patient population of 72 and each was screened for demographic information, including literacy. All patients used inhalers. These patients were randomized to one of the four interventions and then evaluated by their ability to demonstrate proper inhaler technique using a placebo MDI. The effectiveness of each intervention was measured by the patient’s ability to complete each step of proper inhaler technique, and no partial credit was given. The result of the study showed that only 29.2% of the patients were able to do this correctly. There was also a statistically significant increase in correct inhaler technique in the group of patients given direct inhaler technique education.

This study showed that pharmacists can positively influence patent inhaler outcomes (in comparison to other methods) by giving direct patient education. This is important for the advancement of our profession because it shows that we can provide care outside of simply dispensing medications. Studies like this may provide a framework for allowing pharmacists to provide other services.

What other services do you see pharmacists being able to provide in the future?

View the article here:

Axtell S, Haines S, Fairclough J. Effectiveness of Various Methods of Teaching Proper Inhaler Technique: The Importance of Pharmacist Counseling. J Pharm Pract. 2016 Feb 23. pii: 0897190016628961.

Effectiveness of Pharmacist Counseling and Teaching Proper Inhaler Technique

Asthma indicates that approximately 21.1 million adults in the U.S. are diagnosed with asthma and 15.3 million Americans are diagnosed with COPD. Therefore, many Americans are utilizing inhalers for treatment. Many of these people do not have their asthma or COPD under control, because they are misusing their inhalers. In fact, patients with uncontrolled asthma are four times more likely to have improper inhaler techniques.

The study aimed to compare four different techniques in teaching subjects how to use inhalers in order to compare which is the most effective. This study took place in a health fair and indigent clinic and was randomized and non-crossover with 72 subjects. The participants did not know how to use an inhaler and they were assigned to one of four groups. They had to read the inhaler package insert, watch a CDC video demonstrating inhaler technique, watch a YouTube video demonstrating inhaler technique, or receive direct instruction of inhaler technique from a pharmacists. 29.2% of the subjects learned to competently use an inhaler. There was a statistically significant difference for pharmacist direct instruction compared to each of the other techniques. It was concluded that a few minute pharmacist counseling session can greatly increase patient success using their inhalers.

I feel that face-to-face interaction is the best way to communicate with a patient, so it makes sense that pharmacists had the most success. However, I feel that more than 21 of the 72 subjects should have learned how to use their inhaler properly. What more could a pharmacist do to increase these numbers?

Axtell S, Haines S, Fairclough J.  Effectiveness of various methods of teaching proper inhaler technique. J Res Pharm Pract.Published online February 23, 2016. doi: 10.1177/0897190016628961
Journal of Pharmacy Practice February 23, 2016. 0897190016628961.