Relationship between the ability to learn dry-powder inhaler use and the cognitive functions in patients with COPD

Abstract

In this study, it is aimed to assess the relationship between the cognitive functions and the ability to learn the DPI medication use in the inhaler-naïve COPD patients.

Firstly diagnosed inhaler-naïve 30 patients with COPD were included into the study. Standardized cognitive function tests (Mini Mental State Examination, trail making A and B, clock drawing, forward and backward digit span tests, Brown–Peterson Test, verbal fluency test and Geriatric Depression Scale) were administered before the training. At the end of the training, patients were asked to describe the training steps verbally, and then to practice the use of DPI until they were able to use it correctly three times consecutively. The patients then assessed the ease of use of DPI with a 0 to 10 visual analog scale. Ten days later, an independent observer checked the patients for the correct use of DPI and rated their performance as correct or fault.

In the second visit, ten days later, it was observed that 7 patients (24%) were failed to use DPI correctly. Patients who used the inhaler correctly differed from patients who used it incorrectly regarding a number measures. These measures were the total time to complete the training session (p<.01), the total time to complete the practice training (p<.01), the number of practical test errors (p<.05), the ease of use rating (p<.01), the Mini Mental State Examination Z score (p<.01) Trail Making A+B Z Score (p<.01), Brown-Peterson Z Score (p<.05).

Our results showed that cognitive functions were closely related with learning and remembering the use of DPI. These results emphasized the importance of assessment of cognitive function in patients with COPD.