I A Basheti1, N M Obeidat2, W G Ammari3, H K Reddel4. 1. Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science University, Amman, Jordan. 2. Department of Internal Medicine, Respiratory and Sleep Medicine, Faculty of Medicine, Jordan University Hospital, Amman, Jordan. 3. Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan. 4. Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES: To investigate associations between technique with pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) used as controller medication and asthma control variables measured using Asthma Control Test (ACT) scores. DESIGN: In this cross-sectional study, the inhaler technique of asthma patients using pMDIs or DPIs (Turbuhaler® [TH] and Accuhaler Diskus™ [ACC]) were assessed against published inhaler technique checklists. ACT scores (maximum 25, higher score corresponding to better asthma control) were assessed. RESULTS: Of the 130 subjects enrolled in the study (41 TH, 54 ACC and 35 pMDI), inhaler technique scores (out of nine for all devices) were low for TH (4.4 ± 0.9) and ACC (5.4 ± 1.0) compared with pMDI (8.1 ± 0.9) (P < 0.001, one-way analysis of variance). Older age and use of pMDI were associated with better inhaler technique. ACT scores were low, consistent with very poorly controlled asthma (mean TH 13.1 ± SD 3.9, mean ACC 13.3 ± SD 3.9 and mean pMDI 12.8 ± SD 4.2). No significant association between inhaler technique scores and ACT scores was found. More recent asthma diagnosis and a higher level of education were associated with higher ACT scores (better asthma control). CONCLUSION: Asthma control was poor in this population. Lack of a significant association between the inhaler technique score and asthma control may reflect the multiple factors contributing to poor asthma control in the Jordanian population.
OBJECTIVES: To investigate associations between technique with pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) used as controller medication and asthma control variables measured using Asthma Control Test (ACT) scores. DESIGN: In this cross-sectional study, the inhaler technique of asthma patients using pMDIs or DPIs (Turbuhaler® [TH] and Accuhaler Diskus™ [ACC]) were assessed against published inhaler technique checklists. ACT scores (maximum 25, higher score corresponding to better asthma control) were assessed. RESULTS: Of the 130 subjects enrolled in the study (41 TH, 54 ACC and 35 pMDI), inhaler technique scores (out of nine for all devices) were low for TH (4.4 ± 0.9) and ACC (5.4 ± 1.0) compared with pMDI (8.1 ± 0.9) (P < 0.001, one-way analysis of variance). Older age and use of pMDI were associated with better inhaler technique. ACT scores were low, consistent with very poorly controlled asthma (mean TH 13.1 ± SD 3.9, mean ACC 13.3 ± SD 3.9 and mean pMDI 12.8 ± SD 4.2). No significant association between inhaler technique scores and ACT scores was found. More recent asthma diagnosis and a higher level of education were associated with higher ACT scores (better asthma control). CONCLUSION: Asthma control was poor in this population. Lack of a significant association between the inhaler technique score and asthma control may reflect the multiple factors contributing to poor asthma control in the Jordanian population.
Authors: Wanis H Ibrahim; Fatima Rasul; Mushtaq Ahmad; Abeer S Bajwa; Laith I Alamlih; Anam M El Arabi; Dhabia Al-Mohannadi; Mohammed Y Siddiqui; Israa S Al-Sheikh; Azdin A Ibrahim Journal: Can Respir J Date: 2018-12-18 Impact factor: 2.409