The Impact of Theoretical and Practical Guidance Regarding Metered Dose Inhaler Technique on Asthma Patients

    Published on:August 2022
    Journal of Young Pharmacists, 2022; 14(3):327-332
    Original Article | doi:10.5530/jyp.2022.14.64

    Sara Shahid1,2,*, Fahad Ahmed3, Gul Shahnaz1, Muhammad Saqlain1, Muhammad Ans4, Anosh Sana1, Abdul Nazer Ali5, Ahmad Kamal Ariffin Abdul Jamil6, Asma Fareed Khan7,8, Saba Naeem9, Shakeel Ahmad9, Aiman Mahmood4,9, Qandeel Rafi9, Asifa Anwar2, Rabeel Khan2, Naeem Mubarak2

    1Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, PAKISTAN.

    2Department of Pharmacy Practice, Lahore Pharmacy College, Lahore Medical and Dental College, University of Health Sciences, Lahore, PAKISTAN.

    3Faculty of Pharmacy, University of Sargodha, Sargodha, PAKISTAN.

    4University College of Pharmacy, University of the Punjab, Lahore, PAKISTAN.

    5Department of Pharmacy Practice, Geethanjali College of Pharmacy, Hyderabad, Telangana, INDIA.

    6Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, UniSZA, Besut, Terengganu, MALAYSIA.

    7Disciplines of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, MALAYSIA.

    8Children’s Hospital & University of Child Health Sciences, Lahore, PAKISTAN.

    9Department of Pharmaceutics, Lahore Pharmacy College, Lahore Medical and Dental College, University of Health Sciences, Lahore, PAKISTAN.


    Background: Asthma is rapidly increasing globally. Inhalation therapy is the backbone for asthma management due to localized delivery and rapid onset of action. Currently, metered dose inhalers (MDIs) are the most widely prescribed and dispensed inhaler devices worldwide due to the advantage of portability, multiple dose delivery and better efficacy. Objectives: The current study aimed to access the effect of educational intervention on asthma patients’ competency regarding pressurized metered dose inhaler (pMDI) technique. Methods: Asthma patients were recruited from Pakistan Institute of Medical Sciences (PIMS) Islamabad, Pakistan. Inhaler technique steps based upon “National Asthma Education and Preventive Program” (NAEPP) criteria was set as evaluating tool to evaluate competency of asthma patients regarding MDI appropriate technique. Intervention involved educating study subjects (asthma patients) practically through placebo inhaler and theoretically through inhaler technique directed literature brochures. Pre intervention and post intervention inhaler technique competency was accessed and evaluated statistically. Results: Among 207 asthma patients, majority were never instructed by healthcare professional regarding inhaler technique (78.8%). However, most of the patients were observed to have inadequate inhaler technique (76.3%) at baseline. As the result of educational intervention, the competency of patients regarding inhaler technique was significantly enhanced from 11.6% pre-intervention to 34.8% post-intervention (p<0.001), statistically analyzed by McNemar testing. Conclusion: Originally, inhaler technique competency of majority of asthma patients was observed to be inappropriate. However, educational intervention proved to be effective in substantially enhancing the competency of study subjects regarding MDI technique.

    Keywords: Asthma, Inhalation therapy, Metered-dose inhalers, Educational intervention, National Asthma Education and Preventive Program.

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