ASSESSMENT OF INHALER TECHNIQUE OF PATIENTS ADMITTED WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT PULMONOLOGY UNIT KHYBER TEACHING HOSPITAL, PESHAWAR

Abstract

ABSTRACT
Objective: To assess the inhaler technique of patients admitted with acute exacerbation of Chronic Obstructive Pulmonary
Disease.
Patients and Methods: This was a descriptive, cross sectional study conducted at Pulmonology Unit Khyber Teaching
Hospital, Peshawar from October 2009 to October 2010. All patients who were admitted with acute exacerbation of COPD
were recruited for assessment of inhaler technique. Demographic characteristics of patients were recorded and inhaler
technique was assessed after stabilization, using a 6 point scale for metered dose inhaler alone (MDI) alone, MDI with
a spacer device and dry powder inhaler (DPI) and was labeled as good (no mistake), poor (1-3 mistakes) and incorrect
(>3 mistakes). The data was entered into a structured proforma. Mean, median, mode and standard deviation of age,
percentages of sex and inhaler technique assessment for MDI, MDI with spacer and DPI were calculated using SPSS-16.
Results: The mean age of patients was 62 (± 9.32 SD) years, male to female ratio of 1:1.35 and the mean duration of
COPD was 8.81(± 5.72 SD) years. Of total 151 patients, 65 who were prescribed metered dose inhaler (MDI), 61.53%
had incorrect technique, 26.15% had poor technique while only 12.3% had good technique. Similarly, metered dose
inhaler with spacer device was prescribed to 90 patients; the technique was incorrect in 6.6%, poor in 53.3% and good
in 40% patients. Dry powder inhaler was prescribed to 25 patients; the corresponding values were 4.34%, 34.78% and
60.86% respectively.
Conclusion: Majority of the patients with acute exacerbation of COPD had inadequate inhaler technique, and failure
to address this issue may lead to avoidable hospitalizations and unnecessary escalation of the therapy.
Key Words: COPD; Exacerbation; Inhaler technique

Authors: 
Hussain Ahmad
Rukhsana Farooqi
Saadia Ashraf Ashraf
Mukhtiar Zaman Afridi

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