Assessing the Use of Metered Dose Inhalers by Adults with Asthma
Journal of AsthmaPublished 1 January 1989
Bryn Manzella, C. Michael Brooks, James Richards, Richard A. Windsor, Seng‐Jaw Soong, William C. Bailey
Citations69
SJR quartileQ2
SJR score0.57
SNIP0.63
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
It is found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers.
Abstract
The development and analysis of an instrument to evaluate the use of metered dose inhalers by patients in the University of Alabama at Birmingham (UAB) Asthma Program is presented. A total of 238 adult asthma patients demonstrated use of the metered dose inhaler for this analysis. Patient skill in using the inhaler was recorded using the instrument, Inhaler-Use Checklist, developed at UAB. The study found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers.
Keywords
PsychologyMedicine
Psychological BulletinConvergent and discriminant validation by the multitrait-multimethod matrix.
17,061 Citations1959Donald T. Campbell, Donald W. Fiske
This transmutability of the validation matrix argues for the comparisons within the heteromethod block as the most generally relevant validation data, and illustrates the potential interchangeability of trait and method components.
Journal of Nutrition EducationHealth Education Planning: A diagnostic approach
959 Citations1986
This book offers PRECEDE (an acronym for predisposing reinforcing and enabling causes in educational diagnosis and evaluation) as a model for health education planning as well as examples of the application of this framework to 2 settings: public schools and patient care.
PubMedProblems patients have using pressurized aerosol inhalers.
367 Citations1982Crompton Gk
One hundred and thirty-five patients already being treated with drugs by inhalation were found to have a poor inhaler technique, even though most had received instruction on how to use a pressurized aerosol and were considered to be able to use one of these devices correctly.
PubMedSurvey of the clinical use of pressurized aerosol inhalers.
229 Citations1979Stanley W. Epstein, Crnp Manning +2 more
Questions as to the use of pressurized aerosol inhalers were asked of 130 persons presenting for routine pulmonary function studies who had used such a device in the previous year and there were significant differences in performance according to referral diagnosis and regularity of use of inhalers.
AllergyErrors in Inhalation Technique and Efficiency in Inhaler Use in Asthmatic Children
201 Citations1986Susanne S. Pedersen, Lars Frost +1 more
It is found that children under 6 years had a more inefficient and a more faulty technique than older children, but otherwise age did influence the result.
PubMedHow should a pressurized beta-adrenergic bronchodilator be inhaled?
173 Citations1981Stephen P. Newman, D Pavia +1 more
The evidence for the most effective mode or modes of inhalation of pressurized aerosol bronchodilators is reviewed and the applicability of these simple rules to other types of bronchidilator and to all patients, irrespective of their diagnosis or degree of airway obstruction is considered.
The American Journal of MedicineThe adequacy of inhalation of aerosol from canister nebulizers
170 Citations1980Chang Shim, M. Henry Williams
Physicians who prescribe aerosol medication from a canister nebulizer should evaluate each patient for the aerosol inhalation technique, and those who inhale incorrectly should be taught repeatedly until they learn the correct technique and retain it.
British Journal of Diseases of the ChestWhat determines whether an elderly patient can use a metered dose inhaler correctly?
153 Citations1986Stephen C. Allen, Alison Prior
Elderly patients requiring MDI therapy should be carefully selected and properly instructed by the prescribing doctor, and patients who were first prescribed an MDI in hospital were significantly more likely to be competent than those prescribed by the general practitioner.
PubMedClinical consequences of inadequate inhalation technique in asthma therapy.
142 Citations1987Scott D. Lindgren, B Bake +1 more
It is concluded that when a metered-dose aerosol is used in general clinical practice there is a considerable loss of potential efficacy.
Medical Entomology and ZoologyEvaluation of health promotion and education programs.
140 Citations1984Windsor Ra, Tom Baranowski +2 more
This book focuses on the technical skills that staff members of health promotion programs can use to evaluate their programs, and the purposes and expectations of program evaluation are considered.
Medical CareReliability of Information Abstracted from Patients?? Medical Records
136 Citations1978Linda K. Demlo, Paul M. Campbell +1 more
Two recent studies by the Institute of Medicine on the reliability of hospital discharge data abstracted from patients' medical records raise serious questions about the adequacy of information on diagnoses and procedures.
BMJPatient error in use of bronchidilator metered aerosols.
133 Citations1976J OPREHEK, P Gayard +2 more
It was important to find out whether asthmatics used their aerosols correctly, since the drug intake depends mostly on the patient's ability to follow the instructions.
International Journal of PharmaceuticsDrug deposition of pressurized inhalation aerosols I. Influence of actuator tube design
112 Citations1978Folke Morén
It was found that the deposition of drug in the mouth could be reduced significantly by attaching an additional tube to the actuator and the total loss of terbutaline sulphate in actuator, tube and mouth increased compared to the corresponding tests with coordinated inhalation.
PubMedThe value of demonstration and role of the pharmacist in teaching the correct use of pressurized bronchodilators.
106 Citations1983Timothy H. Self, J B Brooks +2 more
The use of an improper technique with metered-dose inhalers decreases the efficacy of the bronchodilators being administered and the need for and value of the demonstration of proper technique with pressurized inhalers is indicated.
American Journal of EpidemiologyASSURING THE QUALITY OF QUESTIONNAIRE DATA IN EPIDEMIOLOGIC RESEARCH
104 Citations1979Leon Gordis
Journal of the Royal Society of MedicineSimple Instructions for using Pressurized Aerosol Bronchodilators <sup>1</sup>
97 Citations1980Stephen P. Newman, Demetri Pavia +1 more
Bronchodilatation has been measured after controlled inhalations of 500 μg terbutaline sulphate given in a systematic series of investigations to 8 patients with reversible airways obstruction and results indicate that patients may release the aerosol at any time during the course of a slow deep inhalation which should be followed by 10 seconds of breath-holding.
BMJMisuse of Inhaled Bronchodilator Agents
97 Citations1965K.B. Saunders
The use and effect of inhaled bronchodilators in out-patients routinely attending a chest department and since the recently developed pressurized aerosols are expensive is examined.
Archives of Internal MedicineDeposition of Aerosols in Pulmonary Disease
79 Citations1973Irwin S. Goldberg
Pathological conditions may possibly affect the deposition of aerosols in the human respiratory tract and the main mechanisms of deposition—inertial impaction, gravitational sedimentation, Brownian diffusion, and turbulent diffusion.
Journal of Allergy and Clinical ImmunologyThe effect of sequential inhalations of metaproterenol aerosol in asthma
68 Citations1980Dov Heimer, Chang Shim +1 more
The data indicate the unsuitability of sequential inhalation for study of dose response of these agents and have important implications with respect to the utilization of bronchodilator aerosols in the treatment of asthma.
ThoraxUse of a special inhaler attachment in asthmatic children.
61 Citations1980Roger Ellul‐Micallef, Folke Morén +2 more
Twelve asthmatic children produced significantly better PEFR measurements when 0.25 mg terbutaline sulphate was administered via an inhaler with the attachment than when an ordinary inhaler was used alone.
British Journal of Diseases of the ChestAn objective assessment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently
47 Citations1981David Godden, Graham K. Crompton
The tube spacer was objectively assessed in a group of patients with reversible airways obstruction who were found to have some difficulty in using conventional inhalers and it was concluded that the tubeSpacer was better than the conventional inhaler in these patients.
BMJMisuse of pressurised nebulisers.
33 Citations1978J E Earis, A. J. Bernstein
The conclusion after previously having experienced three failures with single prophylactic injections of HBIG to three children of HBsAg-positive renal dialysis mothers is that repeated administration of H BIG in high dosage may be of value for babies of highly contagious mothers.
CHEST JournalEnhanced Responses to Aerosolized Bronchodilator Therapy in Asthma Using Respiratory Maneuvers
33 Citations1979D. Jason Riley, Roger T. Liu +1 more
The findings suggest that the bronchodilator response to isoproterenol may be enhanced by inhaling the drug in divided doses sequentially and by delivering the drug near maximal inspiration.
Archives of Pediatrics and Adolescent MedicineUse of a Tube Spacer to Improve the Efficacy of a Metered-Dose Inhaler in Asthmatic Children
25 Citations1986Gary S. Rachelefsky
Under the circumstances of the study, the tube spacer device might enhance the use of the MDI in children who are not properly taught and/or who forget or cannot perform proper technique.
Clinical & Experimental AllergyOptimal use of tube spacer aerosols in asthmatic children
20 Citations1985Susanne S. Pedersen
In a double blind cross‐over study the bronchodilator response after eight different modes of inhalation of terbutaline from a pressurized aerosol with a tube spacer was assessed in fifteen asthmatic children, and slow inspiratory flow rates were found to be associated with a statistically significant increase in response.
American journal of diseases of childrenSustained-Release Theophylline Preparations in Asthmatic Children
11 Citations1986Gary S. Rachelefsky
Analysis of individual patient data did not reveal a predictable relationship between serum theophylline concentrations and results of pulmonary function tests, and the two drugs were equally effective in clinically controlling asthma over the two weeks of treatment.
AllergySimplification of Inhalation Therapy in Asthmatic children
7 Citations1986Susanne S. Pedersen, G. Steffensen
It is concluded that conclusions for the use of spacer aerosols should be substantially simplified and that conclusions from laboratory studies should be tested in the day‐to‐day of asthmatics before these aerosols become widely used.
The Journal of PediatricsSpacer devices for asthma
6 Citations1986Michael T. Newhouse, Myrna Dolovich
International Journal of PharmaceuticsEffect of polysorbate 80 on the apparent partition coefficient of drugs and on their intestinal absorption in the rat II. Phenobarbital
5 Citations1981Ahmed H. Hikal
The apparent partition coefficient of phenobarbital decreased in the presence of polysorbate 80, reaching a minimum at the CMC, then increased markedly at higher concentration, which resulted in a significant increase in the per cent absorbed.