Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Short-term Evaluation of a Comprehensive Education Program Including Inhaler Training and Disease Management on Chronic Obstructive Pulmonary Disease

  • Yoo, Kwang Ha (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Chung, Wou Young (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Park, Joo Hun (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Hwang, Sung Chul (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Kim, Tae-Eun (Department of Clinical Pharmacology, Konkuk University School of Medicine) ;
  • Oh, Min Jung (Office of Biostatistics, Department of Humanities and Social Medicine, Ajou University School of Medicine) ;
  • Kang, Dae Ryong (Office of Biostatistics, Department of Humanities and Social Medicine, Ajou University School of Medicine) ;
  • Rhee, Chin Kook (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yoon, Hyoung Kyu (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Tae-Hyung (Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Kim, Deog Kyeom (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine) ;
  • Park, Yong Bum (Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital) ;
  • Kim, Sang-Ha (Department of Internal Medicine, Wonju Severance Christian Hospital) ;
  • Yum, Ho-Kee (Department of Internal Medicine, Inje University Seoul Paik Hospital)
  • Received : 2017.02.21
  • Accepted : 2017.06.02
  • Published : 2017.10.31
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Abstract

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

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References

  1. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532-55. https://doi.org/10.1164/rccm.200703-456SO
  2. Yoo KH, Kim YS, Sheen SS, Park JH, Hwang YI, Kim SH, et al. Prevalence of chronic obstructive pulmonary disease in Korea: the fourth Korean National Health and Nutrition Examination Survey, 2008. Respirology 2011;16:659-65. https://doi.org/10.1111/j.1440-1843.2011.01951.x
  3. Kim SA, Lee JH, Kim EK, Kim TH, Kim WJ, Lee JH, et al. Outcome of inhaler withdrawal in patients receiving triple therapy for COPD. Tuberc Respir Dis 2016;79:22-30. https://doi.org/10.4046/trd.2016.79.1.22
  4. Zwerink M, Brusse-Keizer M, van der Valk PD, Zielhuis GA, Monninkhof EM, van der Palen J, et al. Self management for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2014;(3):CD002990.
  5. Aydemir Y. Assessment of the factors affecting the failure to use inhaler devices before and after training. Respir Med 2015;109:451-8. https://doi.org/10.1016/j.rmed.2015.02.011
  6. Jarvis S, Ind PW, Shiner RJ. Inhaled therapy in elderly COPD patients; time for re-evaluation? Age Ageing 2007;36:213-8. https://doi.org/10.1093/ageing/afl174
  7. VanderSchaaf K, Olson KL, Billups S, Hartsfield CL, Rice M. Self-reported inhaler use in patients with chronic obstructive pulmonary disease. Respir Med 2010;104:99-106. https://doi.org/10.1016/j.rmed.2009.07.003
  8. Pothirat C, Chaiwong W, Phetsuk N, Pisalthanapuna S, Chetsadaphan N, Choomuang W. Evaluating inhaler use technique in COPD patients. Int J Chron Obstruct Pulmon Dis 2015;10:1291-8.
  9. George J, Kong DC, Thoman R, Stewart K. Factors associated with medication nonadherence in patients with COPD. Chest 2005;128:3198-204. https://doi.org/10.1378/chest.128.5.3198
  10. Vestbo J, Anderson JA, Calverley PM, Celli B, Ferguson GT, Jenkins C, et al. Adherence to inhaled therapy, mortality and hospital admission in COPD. Thorax 2009;64:939-43. https://doi.org/10.1136/thx.2009.113662
  11. Bryant J, McDonald VM, Boyes A, Sanson-Fisher R, Paul C, Melville J. Improving medication adherence in chronic obstructive pulmonary disease: a systematic review. Respir Res 2013;14:109. https://doi.org/10.1186/1465-9921-14-109
  12. Lee JY, Yoo KH, Kim DK, Kim SH, Kim TE, Kim TH, et al. Effects of educational interventions for chronic airway disease on primary care. J Korean Med Sci 2016;31:1069-74. https://doi.org/10.3346/jkms.2016.31.7.1069
  13. Bhatt SP, Kim YI, Wells JM, Bailey WC, Ramsdell JW, Foreman MG, et al. $FEV_1$/$FEV_6$ to diagnose airflow obstruction. Comparisons with computed tomography and morbidity indices. Ann Am Thorac Soc 2014;11:335-41. https://doi.org/10.1513/AnnalsATS.201308-251OC
  14. Vandevoorde J, Verbanck S, Schuermans D, Kartounian J, Vincken W. $FEV_1$/$FEV_6$ and $FEV_6$ as an alternative for $FEV_1$/ FVC and FVC in the spirometric detection of airway obstruction and restriction. Chest 2005;127:1560-4. https://doi.org/10.1378/chest.127.5.1560
  15. Gupta N, Pinto LM, Morogan A, Bourbeau J. The COPD assessment test: a systematic review. Eur Respir J 2014;44:873-84. https://doi.org/10.1183/09031936.00025214
  16. Roggeri A, Micheletto C, Roggeri DP. Inhalation errors due to device switch in patients with chronic obstructive pulmonary disease and asthma: critical health and economic issues. Int J Chron Obstruct Pulmon Dis 2016;11:597-602.
  17. Tommelein E, Mehuys E, Van Hees T, Adriaens E, Van Bortel L, Christiaens T, et al. Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease (PHARMACOP): a randomized controlled trial. Br J Clin Pharmacol 2014;77:756-66. https://doi.org/10.1111/bcp.12242
  18. Vanfleteren LE, Spruit MA, Groenen M, Gaffron S, van Empel VP, Bruijnzeel PL, et al. Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2013;187:728-35. https://doi.org/10.1164/rccm.201209-1665OC
  19. George J, Kong DC, Stewart K. Adherence to disease management programs in patients with COPD. Int J Chron Obstruct Pulmon Dis 2007;2:253-62.
  20. Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Lancet 2007;370:786-96. https://doi.org/10.1016/S0140-6736(07)61382-8
  21. Bourbeau J, Ford G, Zackon H, Pinsky N, Lee J, Ruberto G. Impact on patients' health status following early identification of a COPD exacerbation. Eur Respir J 2007;30:907-13. https://doi.org/10.1183/09031936.00166606
  22. Donaldson GC, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002;57:847-52. https://doi.org/10.1136/thorax.57.10.847
  23. Langsetmo L, Platt RW, Ernst P, Bourbeau J. Underreporting exacerbation of chronic obstructive pulmonary disease in a longitudinal cohort. Am J Respir Crit Care Med 2008;177:396-401. https://doi.org/10.1164/rccm.200708-1290OC
  24. Seemungal TA, Donaldson GC, Bhowmik A, Jeffries DJ, Wedzicha JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000;161:1608-13. https://doi.org/10.1164/ajrccm.161.5.9908022

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