compliancy toward inhaler and assessment of inhaler technique

STUDY ON COMPLIANCY TOWARD INHALER AND ASSESSMENT OF INHALER TECHNIQUE AT HOSPITAL

SULTANAH NORA ISMAIL

PREPARED BY: MUHAMAD ARIFF BIN MAHDZUBDIPLOMA IN PHARMACY

UNIVERSITY TEKNOLOGY MARA (UiTM)

1

ACCORDING TO www.ginasthma.org

It has been observed that a significant number of patient were TEND TO DRAWBACK

the MDI dose

….because of improper techique

Using inhaler

aimobjective

&

patients’ understanding towards their dosage regimen

their ability to perform MDI technique appropriately

determine the level of compliance using inhalers

evaluate if proper techniques of inhalation

are practiced

Methodology

3 month15 August - 15 November 2012

exclusion

inclusion

Adults and children (12 years old above) in any race, gender.

any type of anti-asthmatic Metered Dose Inhaler.

Duration usage above a months.

Patients with any concurrent medical problems, except psychiatric disorders or

behavior problems

Patients under 12

Patients with clinical diagnosis of Chronic Obstructive

Pulmonary Disorder (COPD) even when they may be using

MDI

RESULT

Compliancy toward inhaler technique

Poor

Good

68%

32%

1.Age

Age range

Good Poor

12 to 20 9 2

21 to 30 8 1

31 to 40 11 2

41 to 50 2 14

51 to 60 1 21

61 to 70 2 22

71 to 80 1 12

81 to 90 1 1

Younger Respondent

Older Respondent

2. Education

level

Good Poor

High 30 19

Low 5 56

Education level

Low Education Respondent

High Education Respondent

3. Duration

usage

Good Poor

less then 6 month 1 33

6 month - 1 year 1 24

2 year - 4 year 4 8

5 year - 7 year 9 4

8 year - 10 year 9 4

10 year above 11 2

Duration Usage Inhaler

Duration usa

ge

4. Gender &

race

Good Poor

malay 17 52

chinese 9 14

india 6 5

other 3 4

good poor

male 17 42

female 18 33

Poor

margine is

more than

Good

margine

Dose regiment(As prescribe by doctor)

AS P

RES

CR

IBE b

y

docto

r……

More

than

……

SO

ME

times…

…

LESs……

69%

13% 13%

5%

SIDE EFFECT(after taking inhaler)

Headache Throat Irritation Coughing Tremor tachycardia Oral Thrush0

10

20

30

40

50

60

70

3

65

4

20

14

4

Side Effect Associated with MDI

MOUTH RINSING

Category 10

10

20

30

40

50

60

70

yesnosometimes

Respondent`s alert for washing mouth after using metered dose inhaler (MDI)

INHALER RINSING

Respondent`s alert for cleaning metered dose inhaler (MDI)

Sales

Once WeekIf NessecaryNo

86%

20%4%

TASTE(it is Problem ???????)

Respondent opinion about metered dose inhaler (MDI) operation

24%

76%

taste

yes no

…It is

convenience??

Respondent opinion about

metered dose inhaler

(MDI) operation

97%

3%

convenience

yes no

Pharmacist & patient work together…….

What respondent

says???

YES NO0

20

40

60

80

100

120

Pharmacist and patient should be work together to increase the compliancy of patient toward metered dose inhaler (MDI)

107

3

Requirement thing need to alert by

pharmacist

Requirement need to take alert by pharmacists during counselling session

impro

ve demostr

ation

impro

ve la

nguag

e

provid

e writt

en inform

ation

0102030405060

3024

56

DISCUSSION…….

Due to pre-existing HEALTH BELIEF, related to culture & ethnic

Age

old Chinese culture belief that asthma is caused by the body`s

imbalance of the yin (cool) and yang (heat)

.....MORE MOTIVATED to increase their quality of healthy

Education level

nowadays people are willing to spend a lot of money in

order to improve their quality of health

Patient that has been use the inhaler for a few years.........

1)have BEST CHEMISTRY related with dose regimen and

2) have OWN SKILL on delivering dose to specific target

Duration usage

Dose regiment

they CONFUSE to amount of dose / frequency should take

THROAT IRRITATION (DYSPHONIC)

is most common side effect of inhaler, which affect approximately 1 out of 3

patients

Side effect

Due to myopathy effect...

Washing mouth

• According to the healthtalk.com date of June 13, 2007 with title ‘Management of Asthma’ noted that, mouth rinsing is essential after inhaler usage, in order to prevent complication such as mouth infection or oral thrush

it is important that to watch the inhaler as it can preventing the build up of excess powder that block the hole of releasing the aerosolized form of medication as 18% of ours candidate did not watch inhaler

Inhaler washing

2Feature of ideal inhaler:

1)ease to operate during an attack

2)the effectiveness to deliver the drug

Taste & convenient

Pharmacist should focusing on patient BELIEFS, NEED and patient should WORK toward a set of achievable goal

pharmacist and patient should be work together to increase the compliancy

When healthcare professionals establish the patient wishes, they will

comply it.

• patient can detect some deficient step regarding technique of handling inhaler by refers to the written information given

Provide Written Information