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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03144557
Other study ID # 3064
Secondary ID
Status Completed
Phase N/A
First received May 2, 2017
Last updated May 4, 2017
Start date January 2, 2017
Est. completion date April 30, 2017

Study information

Verified date May 2017
Source Hospital Italiano de Buenos Aires
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study evaluates the implementation of an education protocol and its impact on the correct inhalation technique in COPD patients presenting errors or mistakes. There will be 4 sessions, in each one the inhalation technique will be evaluated using a checklist of steps. Whenever errors are found, the correct use of each device will be educated through verbal explanation and written material will be delivered.


Recruitment information / eligibility

Status Completed
Enrollment 61
Est. completion date April 30, 2017
Est. primary completion date April 30, 2017
Accepts healthy volunteers No
Gender All
Age group 40 Years and older
Eligibility Inclusion Criteria:

- Patients with COPD diagnosed by spirometry (presence of a postbronchodilator FEV1 / FVC ratio <0.7)

- Over 40 years old

- Use any of the following devices: metered dose inhaler, HandiHaler, Turbuhaler, Diskus, Aerolizer

- Have at least one error in the inhalation technique

- Signature of informed consent.

Exclusion Criteria:

- Artificial airway

- Cognitive impairment noted in the medical history

- Hearing loss that complicates the compression of simple orders

- Bilateral amaurosis

- Functional dependence for the use of inhalers

- Presence of abnormal movements in the upper limbs that interfere and / or impede the correct use of the devices

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Education
Education protocol included 4 individual sessions of verbal and graphic instructions to correct inhalation technique in patients with COPD

Locations

Country Name City State
Argentina Hospital Italiano de Buenos Aires Buenos Aires

Sponsors (1)

Lead Sponsor Collaborator
Hospital Italiano de Buenos Aires

Country where clinical trial is conducted

Argentina, 

References & Publications (31)

Área de asma de SEPAR.; Área de enfermería de SEPAR.; Departamento de asma ALAT.. [SEPAR-ALAT consensus for inhaled therapies]. Arch Bronconeumol. 2013 Jun;49 Suppl 1:2-14. Spanish. — View Citation

Brocklebank D, Ram F, Wright J, Barry P, Cates C, Davies L, Douglas G, Muers M, Smith D, White J. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature. Health Technol Assess. 2001;5(26):1-149. Review. — View Citation

Capstick TG, Clifton IJ. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med. 2012 Feb;6(1):91-101; quiz 102-3. doi: 10.1586/ers.11.89. Review. — View Citation

Dolovich MB, Ahrens RC, Hess DR, Anderson P, Dhand R, Rau JL, Smaldone GC, Guyatt G; American College of Chest Physicians.; American College of Asthma, Allergy, and Immunology.. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest. 2005 Jan;127(1):335-71. Review. — View Citation

Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care. 2005 Oct;50(10):1360-74; discussion 1374-5. Review. — View Citation

Geller DE. Comparing clinical features of the nebulizer, metered-dose inhaler, and dry powder inhaler. Respir Care. 2005 Oct;50(10):1313-21; discussion 1321-2. Review. — View Citation

Georges CA, Bolton LB, Bennett C. Functional health literacy: an issue in African-American and other ethnic and racial communities. J Natl Black Nurses Assoc. 2004 Jul;15(1):1-4. — View Citation

Giner J, Basualdo LV, Casan P, Hernández C, Macián V, Martínez I, Mengíbar A. [Guideline for the use of inhaled drugs. The Working Group of SEPAR: the Nursing Area of the Sociedad Española de Neumología y Cirugía Torácica]. Arch Bronconeumol. 2000 Jan;36(1):34-43. Spanish. — View Citation

Goodman DE, Israel E, Rosenberg M, Johnston R, Weiss ST, Drazen JM. The influence of age, diagnosis, and gender on proper use of metered-dose inhalers. Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1256-61. — View Citation

Harvey J, Williams JG. Randomised cross-over comparison of five inhaler systems for bronchodilator therapy. Br J Clin Pract. 1992 Winter;46(4):249-51. — View Citation

Hendeles L, Colice GL, Meyer RJ. Withdrawal of albuterol inhalers containing chlorofluorocarbon propellants. N Engl J Med. 2007 Mar 29;356(13):1344-51. Review. — View Citation

Hess DR, Kallstrom TJ, Mottram CD, Myers TR, Sorenson HM, Vines DL; American Association for Respiratory Care.. Care of the ventilator circuit and its relation to ventilator-associated pneumonia. Respir Care. 2003 Sep;48(9):869-79. — View Citation

Hesselink AE, Penninx BW, Wijnhoven HA, Kriegsman DM, van Eijk JT. Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scand J Prim Health Care. 2001 Dec;19(4):255-60. — View Citation

Inhaler Error Steering Committee., Price D, Bosnic-Anticevich S, Briggs A, Chrystyn H, Rand C, Scheuch G, Bousquet J. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respir Med. 2013 Jan;107(1):37-46. doi: 10.1016/j.rmed.2012.09.017. Epub 2012 Oct 23. Review. — View Citation

Jarvis S, Ind PW, Shiner RJ. Inhaled therapy in elderly COPD patients; time for re-evaluation? Age Ageing. 2007 Mar;36(2):213-8. Epub 2007 Jan 31. — View Citation

McDonald VM, Higgins I, Simpson JL, Gibson PG. The importance of clinical management problems in older people with COPD and asthma: do patients and physicians agree? Prim Care Respir J. 2011 Dec;20(4):389-95. doi: 10.4104/pcrj.2011.00025. — View Citation

Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, Serra M, Scichilone N, Sestini P, Aliani M, Neri M; Gruppo Educazionale Associazione Italiana Pneumologi Ospedalieri.. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011 Jun;105(6):930-8. doi: 10.1016/j.rmed.2011.01.005. Epub 2011 Mar 2. Erratum in: Respir Med. 2012 May;106(5):757. DelDonno, Mario [corrected to Del Donno, Mario]. — View Citation

Melani AS, Bracci LS, Rossi M. Reduced Peak Inspiratory Effort through the Diskus((R)) and the Turbuhaler((R)) due to Mishandling is Common in Clinical Practice. Clin Drug Investig. 2005;25(8):543-9. — View Citation

Molimard M, Raherison C, Lignot S, Balestra A, Lamarque S, Chartier A, Droz-Perroteau C, Lassalle R, Moore N, Girodet PO. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur Respir J. 2017 Feb 15;49(2). pii: 1601794. doi: 10.1183/13993003.01794-2016. Print 2017 Feb. — View Citation

Myers TR. The science guiding selection of an aerosol delivery device. Respir Care. 2013 Nov;58(11):1963-73. doi: 10.4187/respcare.02812. Review. — View Citation

National Clinical Guideline Centre (UK). Chronic Kidney Disease (Partial Update): Early Identification and Management of Chronic Kidney Disease in Adults in Primary and Secondary Care. London: National Institute for Health and Care Excellence (UK); 2014 Jul. — View Citation

Pinto Pereira L, Clement Y, Simeon D. Educational intervention for correct pressurised metered dose inhaler technique in Trinidadian patients with asthma. Patient Educ Couns. 2001 Jan;42(1):91-7. — View Citation

Rau JL. Practical problems with aerosol therapy in COPD. Respir Care. 2006 Feb;51(2):158-72. Review. — View Citation

Rootmensen GN, van Keimpema AR, Jansen HM, de Haan RJ. Predictors of incorrect inhalation technique in patients with asthma or COPD: a study using a validated videotaped scoring method. J Aerosol Med Pulm Drug Deliv. 2010 Oct;23(5):323-8. doi: 10.1089/jamp.2009.0785. — View Citation

van Beerendonk I, Mesters I, Mudde AN, Tan TD. Assessment of the inhalation technique in outpatients with asthma or chronic obstructive pulmonary disease using a metered-dose inhaler or dry powder device. J Asthma. 1998;35(3):273-9. — View Citation

van der Palen J, Klein JJ, Kerkhoff AH, van Herwaarden CL. Evaluation of the effectiveness of four different inhalers in patients with chronic obstructive pulmonary disease. Thorax. 1995 Nov;50(11):1183-7. — View Citation

van der Palen J, Klein JJ, van Herwaarden CL, Zielhuis GA, Seydel ER. Multiple inhalers confuse asthma patients. Eur Respir J. 1999 Nov;14(5):1034-7. — View Citation

Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013 Feb 15;187(4):347-65. doi: 10.1164/rccm.201204-0596PP. Epub 2012 Aug 9. Review. — View Citation

Virchow JC, Crompton GK, Dal Negro R, Pedersen S, Magnan A, Seidenberg J, Barnes PJ. Importance of inhaler devices in the management of airway disease. Respir Med. 2008 Jan;102(1):10-9. Epub 2007 Oct 17. Review. — View Citation

Wright J, Brocklebank D, Ram F. Inhaler devices for the treatment of asthma and chronic obstructive airways disease (COPD). Qual Saf Health Care. 2002 Dec;11(4):376-82. Review. — View Citation

Yawn BP, Colice GL, Hodder R. Practical aspects of inhaler use in the management of chronic obstructive pulmonary disease in the primary care setting. Int J Chron Obstruct Pulmon Dis. 2012;7:495-502. doi: 10.2147/COPD.S32674. Epub 2012 Jul 25. Review. — View Citation

* Note: There are 31 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Changes in the inhalation technique If the patient that presented errors or mistakes corrected inhalation technique Baseline and every session (48-72 hours)
Secondary Type of error Frequent errors in inhalation technique using different inhaler devices Baseline
Secondary Inhalation device Inhaler that presents the greatest number of mistakes Baseline
Secondary Patient's characteristics Characteristics of the patients who do not perform the inhalation technique correctly and those who, despite having completed the education protocol, continue to perform it incorrectly Baseline
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