Evaluation of a structured pharmacist-led inhalation technique assessment service for patients with asthma and COPD in Norwegian pharmacies

Abstract

OBJECTIVE: To investigate whether the inhalation technique improved among patients with asthma and chronic obstructive pulmonary disease after an Inhalation Technique Assessment Service (ITAS), and to assess the patients' and pharmacists' perceptions of ITAS. METHODS: This uncontrolled, pre-post study included 405 patients recruited from 42 Norwegian pharmacies. Inhalation technique was assessed by trained pharmacists before ITAS (baseline), directly after (follow-up 1) and three months after ITAS (follow-up 2), and analyzed statistically using SPSS. Perceptions of ITAS were assessed using a questionnaire. RESULTS: 488 ITAS were performed. At baseline, 8% of the inhalation technique demonstrations were rated as optimal and 31% as acceptable. Following ITAS, this increased to 72% (optimal) and 86% (acceptable). At follow-up 2 inhalation technique remained significantly higher than baseline (optimal: 52%, acceptable: 75%). The median rate of wrong steps decreased from 25% (baseline) to 0% (follow-ups). The usefulness of ITAS was rated 4 on a 5-point Likert scale. CONCLUSION: Inhalation technique improved significantly after ITAS for both new and experienced users and all assessed devices. The technique remained significantly improved at follow-up 2. ITAS was well accepted by pharmacists and patients. PRACTICE IMPLICATIONS: ITAS can contribute to significant improvements in inhalation technique among patients using inhaler devices.