Title: Evaluation of Appropriateness of Inhaled Drug Delivery Systems in COPD Patients
Authors: Dr U.C. Jha, Dr Peyalee Sarkar
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.75
Abstract
Background: Chronic obstructive lung disease (COPD) is a growing health burden for India with a significant mortality of 102.3/1,00,000 and 6,740,000 DALYs out of world total of 27,756,000 DALYs; thus significantly affecting health related Quality of Life in the country. Corner stone of management is via local drug delivery through various inhaler devices and the appropriateness of the technique of use of the devices has direct effect on the dose of drug delivered and thereby on the effectiveness of the treatment.
Objective: Determining common errors in technique of using drug delivering inhaled devices; correcting them and educating patients about correct use of the same.
Method: An observational study on a subset of 200 informed outpatients (diagnosed COPD cases using inhalational devices) across a period of 2 months (15th August 2018-15th October 2018) in the OPD of Darbhanga medical college, Laheriasarai using a proforma for recording all patient details. Techniques (as given in the review of European respiratory society) were assessed based on interviews and observation by a single interviewer. Collected data were analysed using SPSS version 22.
Result: the study showed maximum faulty technique (considered even if one mistake in technique) with MDI (92.3%) followed by Rotahalers (85.4%), MDI with spacer (75.6%) and the least being with nebulisers (68%). Illiterate population had atleast one mistake in 96.6% of subjects while population with higher secondary level education had mistakes upto 42.2%. Results also varied depending on the person teaching the correct use with only 6% self taught patients achieving perfect techniques.
Conclusion: Majority of patients using inhalational devices made one or more errors which can be reduced by simple methods of demonstrating to the patient the correct use as this minor effort can have huge implications in reducing the number of exacerbation episodes by improved drug delivery, thus improving patient management.
