A significant percentage of patients with asthma and COPD do not use their inhalers properly. Experts recommend that in patients with obstructive lung diseases, inhalation technique and patient adherence should be evaluated at every visit. The assessment of inhalation skills depends on the method of evaluation. There are few different methods of assessment of inhalation technique, however none of them is recommended as the most accurate. Therefore, the aim of the study is: 1. to compare three different methods of assessment of inhalation technique in patients with asthma and COPD. These methods include: 1. Checklist of mistakes in inhalation technique (including critical mistakes) 2. 4 grade scale of inhalation technique 3. Assessment by Vitalograph®AIM (Aerosol Inhaling Monitor) 2. to analyze the influence of Vitalograph®AIM based inhalation technique training on inhalation skills One hundred and thirty patients with asthma or COPD, who use inhaled medication on a regular basis will be enrolled. Inhalation technique will be evaluated by two observers independently at the same time with all three methods (checklist, 4 grade scale, Vitalograph®AIM). To compare these methods, the investigators will analyze method reliability and validity. Additionally, inhalation technique will be evaluated 30 minutes after Vitalograph®AIM based training to analyze the potential benefit of its application in practicing inhalation skills.
Asthma and chronic obstructive pulmonary disease (COPD) are common respiratory diseases. Inhaled therapy is the cornerstone of treatment in these two diseases. However, a significant proportion of patients with asthma and COPD do not use their inhalers properly. Experts recommend that in patients with obstructive lung diseases, inhalation technique and patient adherence should be evaluated at every visit, particularly before introducing changes to the patient's inhalation therapy. The assessment of inhalation skills depends on the method of evaluation. There are few different methods of assessment of inhalation technique, however, none of these methods is recommended as the most accurate. Therefore, the aim of the study is: 1. to compare three different methods of assessment of inhalation technique in patients with asthma and COPD. These methods include: 1. Checklist of mistakes in inhalation technique (including critical mistakes) 2. 4 grade scale of inhalation technique 3. Assessment by Vitalograph®AIM (Aerosol Inhaling Monitor) 2. to analyze an influence of using Vitalograph®AIM based inhalation technique training on inhalation skills. Type of study: prospective, interventional, without randomization. Patients with asthma or COPD treated in hospital or in an out-patient clinic will be asked to participate in the study. Study design One hundred and thirty patients with asthma or COPD, who use inhaled medication on a regular basis will be enrolled. Inhalation technique will be evaluated by two observers independently at the same time with all three methods (checklist, 4 grade scale, Vitalograph®AIM). To compare these methods, the investigators will analyze method reliability and validity. The reference assessment will be performed by two experienced pulmonologists. Additionally, inhalation technique will be evaluated 30 minutes after Vitalograph®AIM based training to analyze the potential benefit of its application in practicing inhalation skills. Outcomes 1. Comparison of three different methods of assessment of inhalation technique in patients with asthma and COPD (reliability, validity and accuracy) 2. Difference in the number of mistakes made during inhalation before and after the Vitalograph® AIM based training. Investigators expect that results of this study will allow to identify the most accurate method for assessment of inhalation technique. Furthermore, the impact of Vitalograph®AIM based training on inhalation skills will be assessed..
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Assessment of inhalation technique by 3 methods in every patient
Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw
Warsaw, Poland
Comparison of reliability of assessment of inhalation technique by checklist method in patients with asthma and COPD
Assessment of reliability of checklist method measured by 2 observers by kappa Cohen coefficient
Time frame: baseline
Comparison of reliability of assessment of inhalation technique by 4 grade scale in patients with asthma and COPD
Assessment of reliability of 4 grade scale measured by 2 observers by kappa Cohen coefficient
Time frame: baseline
Comparison of validity of assessment of inhalation technique by checklist method in patients with asthma and COPD
Assessment of validity of checklist method measured by convergence between observer and an expert baseline by kappa Cohen coefficient
Time frame: baseline
Comparison of validity of assessment of inhalation technique by 4 grade scale in patients with asthma and COPD
Assessment of validity of 4 grade scale measured by convergence between observer and an expert baseline by kappa Cohen coefficient
Time frame: baseline
Comparison of validity of assessment of inhalation technique by Vitalograph®AIM in patients with asthma and COPD
Assessment of validity of Vitalograph®AIM method (convergence between assessment of Vitalograph®AIM and an expert)
Time frame: 30 minutes from baseline
Utility of Vitalograph® AIM in inhalation technique training
Difference in number of inhalation mistakes before and after Vitalograph® AIM based training
Time frame: baseline and in 30 minutes
Comparison of repeatability of assessment of inhalation technique by checklist method in patients with asthma and COPD
Assessment of reliability of checklist method measured by 1 observer baseline and in 30 minutes by kappa Cohen coefficient
Time frame: baseline and in 30 minutes
Comparison of repeatability of assessment of inhalation technique by 4 grade scale in patients with asthma and COPD
Assessment of reliability of 4 grade scale measured by 1 observer baseline and in 30 minutes by kappa Cohen coefficient
Time frame: baseline and in 30 minutes
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