Evaluation of inhaler devices device usage skills among the medical personnels (pulmonologist, family physician, nurse), pharmacist and assistant pharmacist

INTRODUCTION: Although, the effective of corticosteroids and bronchodilators with inhaler devices is featured in asthma and COPD, disease control is inadequate. Treatment failure is usually related of improper use of devices. Education of patient is a critical component of treatment
and requirs cooperative effort of doctor, nurse and pharmacist. We aimed to evaluate inhaler device usage skills of doctors,nurses, pharmacist and assistant pharmacist who trains patients.
METHODS: A total number of 120 doctors,nurses, pharmacist and assistant pharmacist included the study. We asked to demostrate the use of each device which are widely used, metered dose inhaler(MDI), diskus, turbuhaler, aerolizer and easyhaler. Correct use of each devices was assessed in ten steps over 10 points.
RESULTS: The mean age of medical personell included the study was 31.8 ± 7.0. %92.5 of participants knew how to use meter dose inhalers, %85 of aerolizer. %70 of participants was trained before about the inhaler device tehcniques. Mean demostration score for meter dose inhaler 6.5±2.4, discus 6.8±2.9, turbuhaler 5.8±3.7, aerolizer 7.4±2.8 and easyhaler 2.9±0.3. Mean demostration score for meter dose
inhaler, discus, turbuhaler,aerolizer, easyhaler 6.3±2.0, 7.3±1.8, 6.6±2.8, 7.7±1.6, 3.5±3.3 in assistant pharmacist, 6.3±2.0, 6.8±2.3, 5.5±3.5, 6.7±2.9, 3.5±3.1 in pharmacist, 6.3±3.1, 6.0±3.7, 4.8±4.2, 7.8±3.5, 3.1±1.3 in nurses, 6.4±2.0, 6.4±3.1, 4.3±4.1,6.2±3.5, 1.4±0.3 in family physician, 9.0±1.1, 9.5±1.0, 9.2±1.3, 9.6±0.8 ve 9.7±0.9 in pulmonologist (p<0.05) respectively. The percentage of true usage techniques were % 58.3 for MDI, %66.7 for discus, %55.8 for turbuhaler, %76.7 for aerolizer, %25.0 for easyhaler.

DISCUSSION AND CONCLUSION: In conclusion we determined high incidence of incorrect usage of inhaler devices among the all groups. We suggest that medical personnel and pharmacist should have adequate and periodically education to increase patient compliance and treatment success.

Saðlýk Personelleri (Uzman Hekim, Aile Hekimi, Hemþire), Eczacý ve Eczane Kalfalarýnýn Ýnhaler Cihaz Kullaným Becerilerinin Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Astým ve KOAH tedavisinde kullanýlan inhaler cihaz ile steroid ve bronkodilatatorlerin etkinliði gösterilmiþ olmasýna raðmen astým ve KOAH ta hastalýk kontrolu yetersizdir. Tedavi yetersizliði genellikle cihazlarý yanlýþ kullanýmýna baðlýdýr. Hasta eðitimi tedavinin kritik bir komponentidir ve hekim, hemþire, eczacýnýn iþbirliðini gerektirir. Çalýþmamýzda hastalara inhaler cihaz eðitimi veren hekim, hemþire, eczacý ve eczane kalfalarýnýn cihaz kullaným becerilerini deðerlendirdik.
YÖNTEM ve GEREÇLER: Çalýþmaya uzman göðüs hastalýklarý hekimi, aile hekimi, hemþire, eczacý ve eczacý kalfasý olarak çalýþan 120 saðlýk personeli alýndý. Sýk kullanýlan ölçülü doz Ýnhaler, diskus, turbuhaler, aorelizor ve easyhaler cihazlarýnýn kullanýlmasýný basamaklý olarak göstermeleri istendi. Doðru kullaným her bir cihaz için 10 basamakta 10 puan üzerinden deðerlendirildi.
BULGULAR: Araþtýrma kapsamýna alýnan saðlýk personelinin yaþ ortalamasý 31.8±7.0’dýr. Ölçülü doz inhaler cihazýný kullanmayý bildiðini ifade edenlerin oraný %92.5, aerolizer kullanmayý bilenlerin oraný %85’tir. Katýlýmcýlarýn %70’i inhaler cihaz kullanýmý ile ilgili eðitim aldýðýný, eðitim alanlarýnda %20’si bu eðitimi eczacýdan aldýðýný belirtmiþtir. Katýlýmcýlarýn ölçülü doz inhaler kullanýmýndan aldýklarý puan ortalamalarý 6.5±2.4, diskus inhaler kullaným ortalamalarý 6.8±2.9, turbuhaler kullaným ortalamalarý 5.8±3.7, inhaler kapsül kullaným ortalamalarý 7.4±2.8, easy inhaler kullaným ortalamalarý ise 2.9±0.3’tür. Alýnan puanlar ölçülü doz inhaler, diskus, turbuhaler, aerolizer ve easyhaler için sýrasýyla eczacý kalfalarýnda 6.3±2.0, 7.3±1.8, 6.6±2.8, 7.7±1.6, 3.5±3.3, eczacýlarda 6.3±2.0, 6.8±2.3, 5.5±3.5, 6.7±2.9, 3.5±3.1, hemþirelerde 6.3±3.1, 6.0±3.7, 4.8±4.2, 7.8±3.5, 3.1±1.3, aile hekimlerinde 6.4±2.0, 6.4±3.1, 4.3±4.1,6.2±3.5, 1.4±0.3, uzman gögüs hekimlerinde 9.0±1.1, 9.5±1.0, 9.2±1.3, 9.6±0.8 ve 9.7±0.9 bulundu (p<0.05). Aletlerde tekniðin iyi düzeyde kullanma uygulanma oranlarý ÖDÝ de % 58.3, diskusta % 66.7, Turbuhaler da % 55.8, aerolizerda % 76.7, easyhalerda % 25.0 olarak bulundu.
TARTIÞMA ve SONUÇ: Sonuç olarak bütün gruplarda yanlýþ kullaným oranýnýn yüksek oldugunu saptadýk. Hasta uyumunu ve tedavi baþarýsýný artýrmak amacý ile saðlýk personelleri, eczacý ve kalfalara yeterli ve düzenli eðitimin verilmesi gerektiðini düþünmekteyiz.