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Year : 2015  |  Volume : 1  |  Issue : 2  |  Page : 80-84

Inhalational Therapy for Airway Disease Among Adult Patients: Compliance is a Major Challenge Toward Effective Management

1 Department of TB and Respiratory Diseases, North DMC Medical College and Hindu Rao Hospital, Delhi, India
2 Department of Pharmacology, North DMC Medical College and Hindu Rao Hospital, Delhi, India
3 Department of Community Medicine, North DMC Medical College and Hindu Rao Hospital, Delhi, India

Correspondence Address:
Sandeep Sachdeva
Department of Community Medicine, North DMC Medical College and Hindu Rao Hospital, Delhi - 110 007
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2394-7438.157914

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Objective: To determine proportion of correct inhalation technique amongst patients with asthma and chronic obstructive pulmonary disease. Methodology: A cross-sectional study involving 100 known subjects of either disease condition using inhaler device for atleast one-year reporting at chest OPD of government hospital were interviewed using pre-tested semi-structured interview schedule and inhalation technique determined by standard observation checklist. Each step was given a score of 'one' if undertaken by patient and 'zero' in case of non-compliance. Results: There were 62% male patients; 27% were illiterate; 92% were married; 32% were current smokers; average age was 50.3 (±14.5) years; 55% and 45% had asthma and COPD respectively; 60% were on MDI device and 40% were using DPI; 23% reported co-morbid (HT/DM) condition and 27% reported occupational dust exposure while more than one-third (36%) reported hospitalization during last one-year due to disease condition. Inspite of clinical requirement, 45% were not taking inhaler therapy regularly and reasons elicited were lack of knowledge (32%), casual attitude (07%), financial constraints (04%) and stigma (01%). On a positive note, patients undertaking regular visit to doctors were also taking inhaler regularly (P < 0.05). However, these positive practices did not translate into satisfactory inhaler performance. Majority (93%) of patients were not taking inhaler as per standard procedure i.e., only three were found undertaking all the 13-steps for MDI while four were following all the 8-steps for DPI use. Mean score (steps undertaken) for MDI user was 6.71 (±3.3) with a range of 0-13 points and 4.4 (±2.4) with a range of 0-8 score for DPI user. On further evaluation, satisfactory performance (minimum essential steps) with regard to either inhaler device was demonstrated by 25% patients only and found to be statistically associated with those not reporting any co-morbidity (P = 0.02). Conclusion: Proper training and compliance could improve inhalation technique.

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