Por favor, use este identificador para citar o enlazar este Item:http://hdl.handle.net/20.500.12105/20424
Título
Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
Autor(es)
Fecha de publicación
2017-04-13
Cita
Klijn Sven L, Hiligsmann M, Evers Silvia MAA, Román-Rodríguez M, Van Der Molen T, Van Boven JFM. Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review. NPJ Prim Care Respir Med. 2017 Apr 13;27:24.
Idioma
Inglés
Tipo de documento
review article
Resumen
With the current wealth of new inhalers available and insurance policy driven inhaler switching, the need for insights in optimal education on inhaler use is more evident than ever. We aimed to systematically review educational inhalation technique interventions, to assess their overall effectiveness, and identify main drivers of success. Medline, Embase and CINAHL databases were searched for randomised controlled trials on educational inhalation technique interventions. Inclusion eligibility, quality appraisal (Cochrane's risk of bias tool) and data extraction were performed by two independent reviewers. Regression analyses were performed to identify characteristics contributing to inhaler technique improvement. Thirty-seven of the 39 interventions included (95%) indicated statistically significant improvement of inhaler technique. However, average follow-up time was relatively short (5 months), 28% lacked clinical relevant endpoints and all lacked cost-effectiveness estimates. Poor initial technique, number of inhalation procedure steps, setting (outpatient clinics performing best), and time elapsed since intervention (all, p < 0.05), were shown to have an impact on effectiveness of the intervention, explaining up to 91% of the effectiveness variation. Other factors, such as disease (asthma vs. chronic obstructive pulmonary disease), education group size (individual vs. group training) and inhaler type (dry powder inhalers vs. pressurised metered dose inhalers) did not play a significant role. Notably, there was a trend (p = 0.06) towards interventions in adults being more effective than those in children and the intervention effect seemed to wane over time. In conclusion, educational interventions to improve inhaler technique are effective on the short-term. Periodical intervention reinforcement and longer follow-up studies, including clinical relevant endpoints and cost-effectiveness, are recommended.
MESH
Asthma | Dry Powder Inhalers | Nebulizers and Vaporizers | Anti-Asthmatic Agents | Pulmonary Disease, Chronic Obstructive | Treatment Outcome | Humans | Drug Delivery Systems | Bronchodilator Agents | Metered Dose Inhalers | Patient Education as Topic
DECS
Resultado del Tratamiento | Enfermedad Pulmonar Obstructiva Crónica | Broncodilatadores | Humanos | Sistemas de Liberación de Medicamentos | Antiasmáticos | Asma | Educación del Paciente como Asunto | Inhaladores de Dosis Medida | Inhaladores de Polvo Seco | Nebulizadores y Vaporizadores
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