Ward based inhaler technique service reduces exacerbations of asthma and COPD
Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: The management of asthma and COPD is largely dependent on patients being able to use their inhaled medication correctly, but poor inhaler technique continues to be a recurring theme in studies and clinical practice. This is associated with poor disease control, increased risk of exacerbations and hospital admissions, and so there is a need to redesign services for patients to optimise their medicines use.
METHODS: A novel ward-based dedicated inhaler technique service was developed, and pharmacy support workers trained to provide this, focusing on optimising inhaler technique using a checklist and recommending protocol-guided inhaler device switches. Inpatients on adult respiratory wards with a diagnosis of exacerbation of asthma or COPD consented to receive this service, and the impact on exacerbations and hospital admissions were compared in the 6-months before and after the intervention.
RESULTS: 266 adults (74 asthma, 188 COPD, and four asthma-COPD overlap) received the inhaler technique service. Six-month exacerbation and hospital admission data were available for 184 subjects. Optimising inhaler technique achieved a significant reduction in the combined asthma and COPD annualised rate of moderate-to-severe exacerbations (Rate Ratio [RR] 0.75, p < 0.05) and annualised rate of hospital admissions (RR 0.57, p < 0.0005). Improvements were also observed in future length of stay (- 1.6 days) and the average cost of admission (-£748).
CONCLUSIONS: This novel inhaler technique service produced a significant reduction in the rate of moderate-to-severe exacerbations of asthma and COPD, and a reduction in the rate hospital admissions, length of stay and average cost of admission.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:187 |
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| Enthalten in: |
Respiratory medicine - 187(2021) vom: 01. Okt., Seite 106583 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Capstick, Toby Gd [VerfasserIn] |
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| Links: |
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| Themen: |
Asthma |
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| Anmerkungen: |
Date Completed 08.02.2022 Date Revised 08.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.rmed.2021.106583 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM330237357 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: The management of asthma and COPD is largely dependent on patients being able to use their inhaled medication correctly, but poor inhaler technique continues to be a recurring theme in studies and clinical practice. This is associated with poor disease control, increased risk of exacerbations and hospital admissions, and so there is a need to redesign services for patients to optimise their medicines use | ||
| 520 | |a METHODS: A novel ward-based dedicated inhaler technique service was developed, and pharmacy support workers trained to provide this, focusing on optimising inhaler technique using a checklist and recommending protocol-guided inhaler device switches. Inpatients on adult respiratory wards with a diagnosis of exacerbation of asthma or COPD consented to receive this service, and the impact on exacerbations and hospital admissions were compared in the 6-months before and after the intervention | ||
| 520 | |a RESULTS: 266 adults (74 asthma, 188 COPD, and four asthma-COPD overlap) received the inhaler technique service. Six-month exacerbation and hospital admission data were available for 184 subjects. Optimising inhaler technique achieved a significant reduction in the combined asthma and COPD annualised rate of moderate-to-severe exacerbations (Rate Ratio [RR] 0.75, p < 0.05) and annualised rate of hospital admissions (RR 0.57, p < 0.0005). Improvements were also observed in future length of stay (- 1.6 days) and the average cost of admission (-£748) | ||
| 520 | |a CONCLUSIONS: This novel inhaler technique service produced a significant reduction in the rate of moderate-to-severe exacerbations of asthma and COPD, and a reduction in the rate hospital admissions, length of stay and average cost of admission | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Asthma | |
| 650 | 4 | |a COPD | |
| 650 | 4 | |a Inhaler devices | |
| 650 | 4 | |a Patient education | |
| 650 | 4 | |a Pharmacy | |
| 700 | 1 | |a Azeez, Nooria F |e verfasserin |4 aut | |
| 700 | 1 | |a Deakin, Gary |e verfasserin |4 aut | |
| 700 | 1 | |a Goddard, Ashleigh |e verfasserin |4 aut | |
| 700 | 1 | |a Goddard, Dawn |e verfasserin |4 aut | |
| 700 | 1 | |a Clifton, Ian J |e verfasserin |4 aut | |
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