• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.91-98
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• 2018

When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.665-672
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• 2015

Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.4
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• pp.418-427
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• 2008

Purpose: This study was done to investigate the relationship of knowledge related to disease, awareness and practice of inhaler use in asthmatic patients. Method: The participants in this research were 124 patients with asthma who used inhalers, and were admitted to hospital or attended outpatient asthmatic clinics. Data were collected using a self-administered questionnaire which consisted of demographic characteristics, illness-related characteristics, and tools to measure knowledge of disease, awareness and practice related to inhaler use. Results: Knowledge related to disease was statistically significantly different for age (p<.001) and marital status (p=.017). The mean score for awareness of inhaler use was significantly higher than the mean score for practice in inhaler use (p<.001). There were significant correlations between awareness and practice of inhaler use (p<.001), knowledge related to disease and awareness of inhaler use (p<.001), and knowledge related to disease and practice of inhaler use (p<.001). Conclusion: Results indicate that due to the variation in degree of illness in patients with asthma, there is a need to develop appropriate education programs for people of different ages and also precise ${\alpha}$ II content for use of inhalers method of checking capacity washing and storing as well as directions about different kinds of the inhalers.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.111-120
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• 2010

Purpose: The purpose of this study was to evaluate the correct use of inhalers and to examine the patients characteristics affecting correct use of inhalers in patients with obstructive pulmonary disease. Method: Subjects were 280 patients with obstructive pulmonary disease who visited the internal pulmonary outpatient departments in 2 university hospitals in Korea. Inhaler use of each patient was assessed using a checklist recommended by the National Asthma Education and Prevention Program Expert Panel. Result: Most subjects used a DPI or MDI. The overall mean score of correct use was 72.09. Most subjects responded they knew well how to use their inhalers. Most frequent error was 'not fully exhaling before inhalation'. A younger age, higher educational level, living with family, and awareness of inhaler use were significantly associated with correct use of inhalers. Conclusion: The findings of this study showed that most of patients were unable to use inhalers correctly even though they had prior educational experiences. Regular assessing of inhaler use and adequate inhaler education considering patients characteristics by nurses are needed.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.192-198
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• 2002

Purpose : It is important to select and use kinds of Inhaler appropriate to the age of the patient and severity of symptoms. Several kinds of Inhaler have been developed and recommended according to each inhaler's resistance and usage method. We evaluated the usable age of 4 inhalers (turbulent flow inhalers, multi unit dose inhalers, breath actuated MDI, and autohalers) by measuring peak inspiratory flow(PIF) using $In-Check^{(TM)}$ Inspiratory Flow Meter. Methods : Ninety three patients aged from 3 to 7 years(mean $57{\pm}12.9$ mo.) who had admitted to CHA hospital from July 2000 to April 2001 were enrolled. Study patients were divided into 4 groups according to age : 3-4 years of age(group A, n=31), 4-5 years of age(group B, n=32), 5-6 years of age(group C, n=18), and 6-7 years of age(group D, n=12). Results : Out of total 93 patients, 23(71%), 27(84%), 17(94%) patients of each group A, B, C and all 12 patients of group D could use the 4 types of inhaler through adequated education. In all four groups, height, body weight and age were significantly correlated(P<0.05). Usable age, height and weight of children who can use turbulent flow inhaler(TFI) were each 8 year 7 month old, 144 cm, 32.0 kg, and those of multi unit dose inhaler(MUD) were 2 year 10 month old, 92 cm, 12.0 kg. Also that of breath-actuated MDI were 1 yr 8 months, 83 cm, 8.5 kg and that of autohaler were 2 yr 8 months, 91 cm, 11.0 kg Conclusion : We concluded that the ability to use inhalers correlated with height, weight and age of the patients. Multi unit dose inhalers, Breath actuated MDI and Autohaler are useful after 3 years of age through adequate education.

• Journal of Medicine and Life Science
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• v.16 no.2
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• pp.43-45
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• 2019

Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.

• Tuberculosis and Respiratory Diseases
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• v.80 no.4
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• pp.377-384
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• 2017

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.

• Tuberculosis and Respiratory Diseases
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• v.85 no.4
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• pp.283-288
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• 2022

Asthma is a chronic inflammatory disease of the airways characterized by varying and recurrent symptoms, reversible airway obstruction, and bronchospasm. In this paper, clinical important studies on asthma published between March 2021 and February 2022 were reviewed. A study on the relationship between asthma and chronic rhinosinusitis, bronchiectasis, and hormone replacement therapy was published. A journal on the usefulness of fractional exhaled nitric oxide for the prediction of severe acute exacerbation was also introduced. Studies on the effect of inhaler, one of the most important treatments for asthma, were published. Studies on the control of severe asthma continued. Phase 2 and 3 studies of new biologics were also published. As the coronavirus disease 2019 (COVID-19) pandemic has been prolonged, many studies have explored the prevalence and mortality of COVID-19 infection in asthma patients.

• Tuberculosis and Respiratory Diseases
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• v.63 no.6
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• pp.491-496
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• 2007

Background: The best way of delivering drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD) is via the inhaled route of administration. However, many patients use inhaler devices incorrectly. To augment the proper use of inhalation medicine and to improve knowledge of the disease and compliance, we have developed a "Computerized Respiratory Service Program" and applied the use of this program to educate patients. Methods: Prospectively, this study was performed in 164 patients with asthma or COPD prescribed with inhaled medication. When inhalation medication was first prescribed, education using a drug model was conducted two times and thereafter every month. In addition, education using a drug model was conducted and the ability of the patient to use inhalation medicine properly was evaluated. Results: A total of 164 patients participated in the sessions more than two times and received education. Fifty-seven patients participated in three sesions. After the patients received education one time, the ability of these patients to use an inhaler had an average score of 20.6. After the patients received education two times, the average score was 21.9. After the patients received education three times, the average score was 22.3, a further increase. The compliance of using the inhaler was 70.1% at the second session and increased to 81.8% at the third session. Conclusion: Feedback education using the "Computerized Respiratory Service Program" will increase the ability of the patient to use an inhaler and consistent education can maintain patient compliance with inhaler use.