Abstract
Objetivos
Objetivos. Identificar si el empleo de información escrita exclusivamente mejora la calidad de uso de aerosoles presurizados en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Comparar la eficacia de la información escrita exclusiva sobre el uso de aerosoles frente a la explicación oral del uso de estos dispositivos por parte del personal de enfermería
Diseño
Estudio de intervención
Emplazamiento
Centro de salud urbano
Participantes
Un total de 120 pacientes con EPOC en tratamiento con aerosoles presurizados
Intervenciones
División aleatoria en tres grupos de 40 personas. En uno de ellos no se aplica ninguna intervención; en otro, intervención mediante explicación oral y en el tercero intervención mediante información escrita
Mediciones principales
Porcentaje de cumplimiento de 5 criterios sobre el correcto uso de aerosoles inicialmente y 3 meses después de la intervención en todos los grupos
Resultados
Inicialmente se aprecia una baja calidad en el uso de aerosoles presurizados en los pacientes con EPOC (cumplimiento medio de criterios del 40%). La calidad de uso aumenta significativamente en ambos grupos de intervención, y no se aprecian diferencias significativas entre ellos. El cumplimiento medio final de criterios en el grupo de información escrita fue del 74%, frente a un 82% en el grupo de información oral
Conclusiones
El uso de información escrita sobre el uso de aerosoles en pacientes con EPOC mejora significativamente su calidad de utilización, en grado similar a su explicación oral
Palabras clave: Aerosoles, EPOC, Utilización, Intervención, Técnica inhalatoria
Abstract
Objectives
To determine whether the use of written information alone improved inhalation technique with pressurized canister inhalers in patients with chronic obstructive pulmonary disease (COPD).To compare the effectiveness of written information versus verbal explanation provided by nursing personnel on the use of inhalers
Design
Interventional study
Setting
Urban health center
Participants
120 patients with COPD treated with pressurized canister inhalers
Interventions
The participants were divided randomly into three groups of 40 patients each. In one group no intervention was used, in the second group verbal explanations were provided, and in the third group written information was provided
Main measures
We recorded percentage compliance with 5 criteria for the correct use of inhalers at the start of the study and 3 months after the intervention in all groups
Results
Initially, performance of the inhalation technique by patients with COPD was poor (mean compliance 40%). Performance improved significantly in both intervention groups, with no significant difference between them. Final mean compliance was 74% in the written information group and 82% in the verbal information group
Conclusions
The use of written information about the use of inhalers for patients with COPD significantly improved utilization to a degree similar to that obtained with verbal explanations
keywords: Aerosols, COPD, Utilization, Intervention, Inhalation technique
Bibliografía
- 1.Carrion Valero F., Maya Martínez M., Fontana Sanchis I., Díaz López J., Marin Pardo J. Inhalation technique in patients with chronic respiratory diseases. Arch Bronconeumol. 2000;36:236–240. doi: 10.1016/s0300-2896(15)30163-0. [DOI] [PubMed] [Google Scholar]
- 2.Hueto J. Evaluación del uso de los inhaladores. Importancia de una correcta instrucción. Arch Bronconeumol. 1990;26:235–238. [Google Scholar]
- 3.Félez M.A., González J.M., Cardona Q., Monserrat J.M., Picado C. Destreza en el manejo de los aerosoles por parte del personal sanitario. Rev Clin Esp. 1991;188:185–187. [PubMed] [Google Scholar]
- 4.Shaw R.J. Inhaled corticosteroids for adult asthma: impact of formulation and delivery device on relative pharmacokinetics, efficacy and safety. Respir Med. 1999;93:149–160. doi: 10.1016/s0954-6111(99)90000-8. [DOI] [PubMed] [Google Scholar]
- 5.Van Zoest J.G., Van der Weij A.M., Duiverman E.J., Akerlund A., Kouwenberg J.M. Nasal peak inspiratory flow through Turbuhaler in children with symptomatic rhinitis and in healthy children. Pediatr Allergy Immunol. 2000;11:256–259. doi: 10.1034/j.1399-3038.2000.00079.x. [DOI] [PubMed] [Google Scholar]
- 6.De Boeck K., Alifier M., Warnier G. Is the correct use of a dry powder inhaler (Turbohaler) age dependent? J Allergy Clin Immunol. 1999;103:763–767. doi: 10.1016/s0091-6749(99)70417-3. [DOI] [PubMed] [Google Scholar]
- 7.Brand P., Meyer T., Sommerer K., Weber N., Scheuch G. Alveolar deposition of monodisperse aerosol particles in the lung of patients with chronic obstructive pulmonary disease. Exp Lung Res. 2002;28:39–54. doi: 10.1080/019021402753355526. [DOI] [PubMed] [Google Scholar]
- 8.Broeders M.E., Molema J., Vermue N.A., Folgering H.T. Peak inspiratory flow rate and slope of the inhalation profiles in dry powder inhalers. Eur Respir J. 2001;18:780–783. doi: 10.1183/09031936.01.00240301. [DOI] [PubMed] [Google Scholar]
- 9.Grupo de trabajo de la SEPAR . Normativa sobre la utilización de fármacos inhalados. Sociedad Española de Neumología y Cirugía Torácica (SEPAR) Doyma; Barcelona: 1997. [Google Scholar]
- 10.Hesselink A.E., Penninx B.W., Wijnhoven H.A., Kriegsman D.M., Van Eijk J.T. Determinants of an incorrect inhalation technique in patients with asthma or COPD. Scand J Prim Health Care. 2001;19:255–260. doi: 10.1080/02813430152706792. [DOI] [PubMed] [Google Scholar]
- 11.Protocolo Epoc Fmc. 2000;7(Supl 1):37. [Google Scholar]
- 12.Wilkinson L. Systat: the system for statistics (v. 5.0) Systat; Evanston: 1990. [Google Scholar]
- 13.Madueño Caro A.J., Martín Olmedo P.J., García Marti E., Benítez Rodríguez E. Evaluation of theory-practice knowledge on inhalation systems in primary care physicians, post-graduates in training and undergraduates. Aten Primaria. 2000;25:639–643. doi: 10.1016/S0212-6567(00)78586-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Pereira L.P., Clement Y., Simeon D. Educational intervention for correct pressurised metered dose inhaler technique in Trinidadian patients with asthma. Patient Educ Couns. 2001;42:91–97. doi: 10.1016/s0738-3991(00)00090-2. [DOI] [PubMed] [Google Scholar]
- 15.Kamps A.W., Van Ewijk B., Roorda R.J., Brand P.L. Poor inhalation technique, even after inhalation instructions, in children with asthma. Pediatr Pulmonol. 2000;29:39–42. doi: 10.1002/(sici)1099-0496(200001)29:1<39::aid-ppul7>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
- 16.Rydman R.J., Sonenthal K., Tadimeti L., Butki N., McDermott M.F. Evaluating the outcome of two teaching methods of breath actuated inhaler in an inner city asthma clinic. J Med Syst. 1999;23:349–356. doi: 10.1023/a:1020525116505. [DOI] [PubMed] [Google Scholar]
- 17.Kemp J.P. Study designs and challenges in clinical studies conducted in infants and children with asthma. J Allergy Clin Immunol. 1999;104:184–190. doi: 10.1016/s0091-6749(99)70060-6. [DOI] [PubMed] [Google Scholar]