Inhaler technique knowledge and skills before and after an educational program in obstructive respiratory disease patients: A real-life pilot study

Introduction and objective: Patients present poor knowledge and skills about their respiratory disease and inhaler device. We aimed to: (1) evaluate COPD and asthmatic patients' ability to manage inhaled drugs (2) identify differences among devices and (3) correlate clinical data with patient ability. Material and methods: Patients (n = 134) admitted for pulmonary rehabilitation (PR) were given an ad-hoc questionnaire covering 0% as the worst and 100% the best value of global ability (indicating the sum of knowledge and skills in managing inhaled drugs) at baseline (T0) and discharge (T1). Educational program was provided during PR. Setting of rehabilitation, age, sex, diagnosis, spirometry, CIRS score, level of autonomy to use medications, if naive about PR, educational level, and number/type of prescribed inhaled drugs were recorded. Results: Most patients used 1 drug while 37% used 2 drugs. DPIs were the main device prescribed. At baseline, patients' mean level of knowledge and skills were 73% and 58%, respectively. There was a significant difference in level of skills (p = 0.046) among device families, DPIs resulting worst and pMDIs best. Global ability, skills and knowledge improved after educational support (p < 0.001) but did not reach the optimal level, 88%, 87% and 89%, respectively. Baseline global ability was positively correlated to female gender, younger age, previous PR access, outpatient status, higher education level and GOLD D class. Conclusions: At hospital admission, global ability was not optimal. Education may improve this, irrespective of the type of device used, in particular in male, elderly, naive to PR, low educational level patients. & COPY; 2020 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espan & SIM;a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).