Using face-to-face training and multimedia demonstrations for improvement of MDI and DPI inhaler technique among Asthmatic patients in the Chest Referral Clinic of Tikur Anbessa Specialized Hospital: A Quality Improvement Project
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Date
2024-03
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Addis Ababa University
Abstract
Background: Asthma is the most common chronic respiratory illnesses in the world causing
cumbersome morbidity and mortality. Control of asthma symptoms has been suboptimal
worldwide and multiple studies have documented that asthma control in Ethiopia has been as low
as 24%. Poor inhaler techniques are one of the most important contributing factors to poor asthma
control. Although multiple studies have documented the prevalence of poor inhaler techniques in
Ethiopia, there have not been quality improvement projects done with in the country to provide
evidence and outcome-based guidance for the health system in improving our asthmatic patients’
inhaler techniques and thus, their asthma control.
Objectives: This quality improvement project aims to assess the impact of face-to-face
demonstrations and multimedia demonstrations in improving the MDI and DPI inhaler techniques
of asthmatic patients in the chest referral clinic of TASH.
Method: 30 asthmatic participants from the Chest Clinic of Tikur Anbesssa Specialized hospital
who were taking either DPI and/or MDI inhalers had been recruited after assessing for baseline
characteristic and baseline inhaler technique by using an adopted checklist from previous studies.
Baseline asthma symptom control was assessed using ACT tools.
Recruited participants were given face-to-face demonstrations by trained health care
professionals. These face-to-face demonstrations were aided by easy-to-use pamphlet pictograms
and adopted videos. Inhaler techniques and asthma control were reassessed by adopted checklists
and ACT tool respectively at 4 weeks after demonstrations and trainings had been given.
Eventually the preintervention and postintervention results were analyzed and compared to
quantify the impacts brought about by the implemented trainings.
Results This study has proved to show that face-to-face demonstrations aided with pamphlet
pictograms had brought about a tangible improvement in the total score of proper inhaler
technique steps used by the participants. There has been a significant improvement in 5 steps of
MDI inhaler technique steps with an increment in total correct steps (P<0.001) and 6 out of 9
steps of DPI inhaler technique with an increment in total correct steps (P <0.001). There was an
improvement of proper inhaler technique among participants increasing from 10.5% to 52.6% for
participants using DPI inhalers (P=0.007)and from 7.1% to 35.7% (P=0.011) for those using MDI
inhalers.
Conclusion- Face-to-Face demonstrations of MDI and DPI techniques among groups of patient w
aided with pictogram pamphlet has significantly increased correct inhaler technique among
asthmatic patients. Patients have also approved of using the pamphlets used as easy to understand
and helpful in improving their inhaler technique.
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Keywords
Asthma, Inhaler Technique, TASH, Ethiopia, Asthma Control