The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients

 

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dc.contributor.advisor Van Zyl-Smit, Richard
dc.contributor.author Perumal, Rubeshan
dc.date.accessioned 2021-09-15T16:00:06Z
dc.date.available 2021-09-15T16:00:06Z
dc.date.issued 2020_
dc.identifier.citation Perumal, R. 2020. The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients. . ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/33928 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/33928
dc.description.abstract Background Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD. Method We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique. Results During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were: failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breathhold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95%CI 1.13 – 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1 – 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01 – 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate:< 3 trials (aOR 0.35, 95% CI 0.19 – 0.66) and ≥3 trials (aOR 0.17, 95% CI 0.07 – 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience. Conclusion This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and in particular, multiple previous clinical trial participation significantly reduced the risk of errors.
dc.subject Pulmonology
dc.title The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients
dc.type Master Thesis
dc.date.updated 2021-09-15T02:09:50Z
dc.language.rfc3066 eng
dc.publisher.faculty Faculty of Health Sciences
dc.publisher.department Department of Medicine
dc.type.qualificationlevel Masters
dc.type.qualificationlevel MPhil
dc.identifier.apacitation Perumal, R. (2020). <i>The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/33928 en_ZA
dc.identifier.chicagocitation Perumal, Rubeshan. <i>"The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2020. http://hdl.handle.net/11427/33928 en_ZA
dc.identifier.vancouvercitation Perumal R. The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients. []. ,Faculty of Health Sciences ,Department of Medicine, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/33928 en_ZA
dc.identifier.ris TY - Master Thesis AU - Perumal, Rubeshan AB - Background Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD. Method We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique. Results During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were: failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breathhold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95%CI 1.13 – 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1 – 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01 – 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate:< 3 trials (aOR 0.35, 95% CI 0.19 – 0.66) and ≥3 trials (aOR 0.17, 95% CI 0.07 – 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience. Conclusion This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and in particular, multiple previous clinical trial participation significantly reduced the risk of errors. DA - 2020_ DB - OpenUCT DP - University of Cape Town KW - Pulmonology LK - https://open.uct.ac.za PY - 2020 T1 - The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients TI - The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients UR - http://hdl.handle.net/11427/33928 ER - en_ZA


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