PT  - JOURNAL ARTICLE
AU  - Josef Micallef
AU  - Lara Angelle Micallef
AU  - Caroline Gouder
TI  - Comparison of asthma and COPD patients' perception of appropriate metered-dose inhaler technique with a questionnaire and supervision based reference standard
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P4011
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P4011.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P4011.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Aim:To compare patient perception of correct metered-dose inhaler (MDI) technique with what is considered to be the right technique using a questionnaire and under direct supervision.Method:Asthmatic and COPD patients randomly recruited over a seven-month period from the medical wards and respiratory outpatients clinics, answered a standard questionnaire, which included patient self-assessment out of a maximum score of 10. This was followed by formal scoring out of a maximum score of 8, based on eight steps for proper MDI technique. The inhaler technique was scrutinised under direct supervision by the interviewer. The data collected was then analysed using Spearman's correlation.Results:A total of 174 patients on MDI treatment were included: 118 (67.8%) were asthmatics and 56 (32.2%) COPD patients. Eighty-six asthmatics rated themselves at 9 or 10 on self-assessment but only 21 (17.8%) managed a maximum score of 8 on questionnaire and direct supervision (p=0.007). As regards COPD patients, 31 (55.4%) had a self-assessment score of 9 or 10 with only 3 patients (5.4%) managing a full score on objective assessment (p=0.04).Conclusion:There is a significant difference in both asthmatic and COPD patients comparing self- assessment and proper MDI technique. Most assume their technique is correct but medical supervision shows otherwise. Self-assessment shows COPD patients to be more uncertain with MDI technique and only few master it fully when compared to asthmatics. Revision and reinforcement of technique by professionals is necessary during admissions and follow up visits to decrease exacerbations and hospital visits.