Poudel RS, et al. – The benefit of hospital pharmacy intervention on the current status of dry powder inhaler (Rotahaler) technique in patients with asthma and chronic obstructive pulmonary disease (COPD) attending the Chitwan Medical College Teaching Hospital in the Central Development Region, Nepal and the factors associated with the correct use, were explored. This study revealed inadequate current status of Rotahaler technique in these patients. A single hospital pharmacy intervention could significantly improve the correct use of the technique. This outcome emphasized the role of hospital pharmacies in the improvement of inhaler technique.

Methods

• Researchers performed a pre–post interventional study at the outpatient pharmacy in a teaching hospital of the Central Development Region, Nepal, in patients with asthma and COPD currently using a Rotahaler device.
• They computed patients’ demographics and Rotahaler technique before intervention.
• The pharmacist educated and trained those who failed to demonstrate the correct technique, and their technique was reassessed after 2 weeks of intervention.
• For statistical analysis, they conducted descriptive statistics, including Wilcoxon signed rank test, Mann–Whitney U test, Spearman’s correlations and Kruskal–Wallis test.

Results

• Results revealed that before intervention, only 5.7% (10 of 174) of the patients demonstrated the correct Rotahaler technique and the most common errors observed were failure to breathe out gently before inhalation (98.8%) and failure to hold breath for about 10 seconds after inhalation (84.8%).
• 67.1% of the patients showed their technique correctly (p≤0.001) and failure to breathe out gently before inhalation was the most common error (27.44%), after the intervention (n=164).
• An association of age (p=0.003), previous instruction (p=0.007), patient’s education level (p=0.013) and source of instruction (p<0.001) with an appropriate technique before intervention, was reported.
• On the other hand, age (p=0.024), duration of therapy (p=0.010) and gender (p=0.008) were the factors correlated with correct usage after intervention.