Reportedly, cognitive impairment (Mini-Mental State Examination score < 24) is associated with incorrect use of inhalers in older adults. Previous studies have reported that cognitive impairment, which is commonly observed in older adults, is significantly associated with incorrect use of inhalers and reduced ability to retain proper inhalation techniques. These include use of multiple devices, older age, low educational level, reduced manual dexterity and strength, lack of previous inhaler instructions, and cognitive impairment. Various factors have been reported to be associated with incorrect use of inhalers. However, errors during the use of inhalers are common. Inhalation devices have been widely used for several years. Poor inhalation techniques have been associated with unscheduled use of healthcare resources and poor disease control. Inhalation therapy is the cornerstone of pharmacological treatment, and correct use of inhaler devices is essential. However, pharmacological therapy can reduce the symptoms of COPD, improve exercise tolerance and health status, and prevent exacerbations. Assessment of cognitive function combined with technical re-assessment and repeated training should improve COPD management.Ĭhronic obstructive pulmonary disease (COPD) is a highly prevalent health condition worldwide. Cognitive impairment (MoCA score ≤ 16) independently predicted the ability of COPD patients to maintain proper inhaler technique. However, the number of patients following proper technique had decreased at 1 month after training. Conclusionsįace-to-face training by pharmacists improved patient performance. 372 ± 92 m, p = 0.009) had significantly improved in patients demonstrating the correct technique, and CAT score met the minimal clinically important difference. Multivariable analysis revealed that MoCA score ≤ 16 was independently associated with a critical error at 1 month after training (adjusted odds ratio: 12.7, 95% confidence interval: 1.8–88.2, p = 0.010). At 1 month, the number of patients demonstrating the correct technique decreased across all devices. Immediately after training, all patients used dry powder inhalers correctly and 88.1% used pressurized metered-dose inhalers correctly. ![]() The mean age was 73.0 ± 9.0 years, and 75.8% patients had moderate/severe COPD. Sixty-six patients with COPD who demonstrated at least one critical error during the use of any controller inhaler were enrolled. The Montreal Cognitive Assessment (MoCA) score, pulmonary function tests, 6-min walk distance (6 MWD), modified Medical Research Council scale score, and COPD Assessment Test (CAT) score were evaluated. Inhaler technique was re-assessed immediately after and at 1 month after training. Patients demonstrating improper inhaler use were trained face-to-face by pharmacists. This prospective study was conducted at the COPD clinic of Siriraj Hospital (Bangkok, Thailand). We aimed to investigate the inhaler technique in patients with COPD, to compare it immediately after and at 1 month after training, and to identify the predictors of incorrect inhaler use at 1 month after training. Maintaining correct inhaler technique is crucial in the management of chronic obstructive pulmonary disease (COPD).
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