Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Effectiveness of an Educational Intervention for Managing Inhalers in Chronic Obstructive Pulmonary Disease (COPD) Patients in Primary Care: A Randomized Clinical Trial
Given the importance of the correct use of inhalers by patients with Chronic Obstructive
Pulmonary Disease (COPD) for the appropriate treatment of the disease, the self-care
programme which will be assessed will consist of an educational intervention on the correct
use of inhalers.
For this aim, we have designed this study to assess the influence of both individualized and
collective self care programmes about the correct use of inhalers improves the functional
state of patients with COPD compared to when there is no educational intervention.
One of the key aspects for treating COPD is therapy with inhalation devices. Regarding the
correct use of these devices, the international evidence showing that inhalers are not
properly used, and in Spain, to the point that the inhaled therapy will fail if it is not
accompanied by health education.
More recent studies touch upon the importance of nurses, physicians and other medical staff
teaching the correct use of the inhaler. Apart from education, other factors play an
important role when it comes to using the inhaler correctly: sex, age, level of education,
polymedicated patients who use several kinds of devices, patients who are not aware of their
disease and, finally, what is called therapeutic non-fulfillment.
The first report of the effectiveness of a self care programme aimed at the acquisition of
self care abilities and behavior change was by Worth. Unfortunately this pilot study was not
controlled and only studied a small sample of patients with COPD. There were impressive
reductions in the frequency of irritations and house visits by the GP, but no changes in
pulmonary function were found.
Several clinical trials have been carried out to evaluate the effectiveness of education
programmes and self care in COPD. In the Cochrane revision (up-date 2007), no conclusions
could be drawn about the effectiveness of self-control due to the great diversity of
variables measured in the few studies published. Based on the antecedents presented, it is
evident that COPD is a disease which is difficult to control in daily clinical practice, and
that this inadequate control has a significant impact not only on the health of the patient
who has this disease, but also on society and the economy.
To improve the control of COPD, the Primary Care physician needs simple and fast intervention
to allow him or her to objectively improve the level of control of the disease that these
patients have. The objective of self care is to teach patients the necessary aptitudes to
carry out specific medical regimes for the treatment of COPD, to guide patients in how to
have healthy habits and to lend emotional support to patients to help control their disease
;
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