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The Impact of Adding a Training Device to Familiar Counselling on Inhalation Technique and Pulmonary Function of Asthmatics

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Abstract

Introduction

We have investigated the effect of adding a pressurized metered dose inhaler (pMDI) training device to verbal counselling on pulmonary function and inhalation technique.

Methods

A total of 304 adult asthmatic subjects (> 18 years old) were enrolled in a 3-month study of assessment and education. They were divided into an investigation group (Trainhaler plus Flo-Tone and verbal counselling, n = 261, mean age 49.2 years) and a control group (verbal counselling only, n = 43, mean age 48.7 years). Pulmonary function and inhalation technique were evaluated, mistakes noted, and the correct technique advised at three consecutive monthly visits. Visits also included verbal pMDI counselling (both groups) and training device coaching (investigation group).

Results

By visit 2, the mean number of technique errors decreased significantly (p < 0.05) in both groups (investigation group p < 0.001). The investigation group demonstrated a marked decrease in the frequency of the critical error of maintaining a slow inhalation rate until the lungs are full—a technique difficult to learn via verbal counselling alone. The improvement in pulmonary function was significant from the second clinic visit in the investigation group (p < 0.05) and from the third visit in both groups (p < 0.001).

Conclusions

Use of a training device combined with verbal counselling improved inhalation technique. An earlier, significant improvement was also noted in pulmonary function.

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Acknowledgements

We thank the participants of the study.

Funding

There was no external funding for this study itself. Clement Clarke International Limited (CCIL) funded the article processing charges. CCIL is the manufacturer and distributor (direct in UK and through third parties in other countries) of the Trainhaler® and Flo-Tone® devices. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.

Medical Writing Assistance

Medical writing assistance came from Alexis Harper of Jalcyon Ltd. Clement Clarke International Limited (CCIL) funded the medical writer/editor fluent in English science writing to assist the authors in the presentation of the final text. The scientific authors were provided with successive versions and queries for resolution throughout the editing process.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Authorship Contributions

Mina Nicola: Experiment, data entry, writing. Ahmed A. Alberry: Concept, study design, and review. Ossama Mohamed Mahmoud Sayed: Concept, study design. Raghda R.S. Hussein: Concept, study design. Haitham Saeed: Modelling. Mohamed E. Abdelrahim: Concept, planning of study design, review, and writing. All authors have read and approved the manuscript.

Disclosures

Mina Nicola, Ahmed Elberry, Ossama Sayed, Raghda Hussein, Haitham Saeed, and Mohamed Abdelrahim have nothing to disclose.

Compliance with Ethics Guidelines

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Ethical approval was obtained from the hospital ethical committee and written consent was given by the patients.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Clinical Pharmacy Department, Faculty of Pharmacy, Beni Suef University, Beni Suef, Egypt

    Mina Nicola, Raghda Hussein, Haitham Saeed & Mohamed Abdelrahim

  2. Clinical Pharmacology Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt

    Ahmed Elberry

  3. Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni Suef University, Beni Suef, Egypt

    Ossama Sayed

  4. Clinical Pharmacy Department, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt

    Mohamed Abdelrahim

Authors
  1. Mina Nicola
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  2. Ahmed Elberry
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  3. Ossama Sayed
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  4. Raghda Hussein
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  5. Haitham Saeed
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  6. Mohamed Abdelrahim
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Corresponding author

Correspondence to Mohamed Abdelrahim.

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Nicola, M., Elberry, A., Sayed, O. et al. The Impact of Adding a Training Device to Familiar Counselling on Inhalation Technique and Pulmonary Function of Asthmatics. Adv Ther 35, 1049–1058 (2018). https://doi.org/10.1007/s12325-018-0737-6

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  • DOI: https://doi.org/10.1007/s12325-018-0737-6

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