Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

Abstract 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 eff...

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Autores principales:	Sven L. Klijn, Mickaël Hiligsmann, Silvia M. A. A. Evers, Miguel Román-Rodríguez, Thys van der Molen, Job F. M. van Boven
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/6be77393b54c4f808ef40351fbfaba9b
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spelling	oai:doaj.org-article:6be77393b54c4f808ef40351fbfaba9b2021-12-02T15:18:51ZEffectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review10.1038/s41533-017-0022-12055-1010https://doaj.org/article/6be77393b54c4f808ef40351fbfaba9b2017-04-01T00:00:00Zhttps://doi.org/10.1038/s41533-017-0022-1https://doaj.org/toc/2055-1010Abstract 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.Sven L. KlijnMickaël HiligsmannSilvia M. A. A. EversMiguel Román-RodríguezThys van der MolenJob F. M. van BovenNature PortfolioarticleDiseases of the respiratory systemRC705-779ENnpj Primary Care Respiratory Medicine, Vol 27, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the respiratory system RC705-779
spellingShingle	Diseases of the respiratory system RC705-779 Sven L. Klijn Mickaël Hiligsmann Silvia M. A. A. Evers Miguel Román-Rodríguez Thys van der Molen Job F. M. van Boven Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
description	Abstract 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.
format	article
author	Sven L. Klijn Mickaël Hiligsmann Silvia M. A. A. Evers Miguel Román-Rodríguez Thys van der Molen Job F. M. van Boven
author_facet	Sven L. Klijn Mickaël Hiligsmann Silvia M. A. A. Evers Miguel Román-Rodríguez Thys van der Molen Job F. M. van Boven
author_sort	Sven L. Klijn
title	Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
title_short	Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
title_full	Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
title_fullStr	Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
title_full_unstemmed	Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review
title_sort	effectiveness and success factors of educational inhaler technique interventions in asthma & copd patients: a systematic review
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/6be77393b54c4f808ef40351fbfaba9b
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_version_	1718387450459455488

Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

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