Postma, W.R. (2016) How COPD patients think about inhaler technique and instruction : A qualitative, explorative study. thesis, Medicine.
Full text available on request.Abstract
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the world. Improper inhaler technique among COPD patients is a main problem, with about 80% of patients making at least one error in inhaler technique. Errors in inhaler technique are associated with poor disease control and higher risk of hospital admissions. Main learning theories mention the importance of feedback in the learning process. Objectives: To explore the experiences and opinions of young COPD patients (aged 45-65 years) with their inhaler technique and inhaler instruction. Methodology: We developed a semi-structured interview protocol for COPD patients. Patients were recruited by General practices. In total 12 participants (8 male, age range 48-65 years) from the North of the Netherlands were interviewed in their home situation. Interviewing continued until saturation was achieved. The interviews were audio-recorded, transcribed verbatim, analysed and coded using NVivo 11 coding software. Inhaler technique of patients was video-recorded. Patients watched a video instruction and read a patient information leaflet. Medical history questionnaire, Clinical COPD Questionnaire (CCQ) and medical information from the general practitioner (GP) were used to describe study population. SPSS was used for descriptive statistics. Video-recorded inhaler technique was evaluated by a respiratory nurse. Results: In general patients wanted to receive a professional, individual instruction on inhaler technique provided by the same health care provider as responsible for COPD follow-up. Some patients were explicitly negative about receiving an instruction at the pharmacy. Patients were positive about placebo demonstration by the instructor, and practicing of and receiving feedback on inhaler technique. They would like to be told why specific steps should be performed in inhaler technique. Video instruction is considered to be a good tool in inhaler instruction by most patients. Some patients preferred a patient information leaflet instead or a combination. 21 inhaler devices were used (6 types of devices), 81% of them were used insufficient. Patients thought they performed sufficient inhaler technique in 95% of the cases. After receiving video and written instruction, patients were still not aware of the errors they made. Patients’ knowledge of inhaler technique was limited. Only a few of the specific steps of inhaler technique could be mentioned by patients. Knowledge about why specific steps should be performed was even more limited. Conclusion: COPD patients (aged 45-65 years) preferred to receive a professional, individual inhaler instruction combined with a video instruction. The importance of placebo practicing and feedback in inhaler instruction was mentioned by patients. Patients did barely recognize errors in their own inhaler technique, even after receiving video instruction. Knowledge about inhaler technique was limited, however, patients think proper inhaler technique is important.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Molen, Prof. dr. T. van der and Daily supervisor: and Metting, Drs. E.I. and Location: UMCG, department of General Practice |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:53 |
| Last Modified: | 25 Jun 2020 10:53 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1414 |
Actions (login required)
 |
View Item |