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Krenek B.1, Zipko H.2, Pohl W.3
1Hospital Hietzing, Department of Physical Medicine and Rehabilitation, Vienna, Austria, 2Medical University of Vienna, Biology, Medical Statistics, Vienna, Austria, 3Medical University of Vienna, Pulmonology, Vienna, Austria
Background: Although the benefits of inhalation for COPD patients are well established, deficits in the choice and education of inhalation devices by medical personnel adapted to the patient's situation are often found. This may lead to insufficient dosage of inhaled drugs, leading not only to disease progression and poor quality of life but also to difficulties in respiratory physiotherapy in COPD patients.
Purpose: The aim of the study was the evaluation of the medical staff's knowledge about the correct application of different types of inhalers in a community hospital. Additionally, the improvement of knowledge of the staff based on dedicated training material was a focus of the study.
Methods: Vienna Community Ethics from the KAV committee approval has been obtained prior to the study
(EK 13-235-VK). Performing an anonymous follow-up study design, a total of 198 questionnaires from six departments with 441 out of 1100 beds were analyzed to assess: (a) general knowledge about the usage of 3 commonly used inhalers, (b) correct application and (c) improvement of knowledge based on dedicated training sessions after the first run of the study. After the preceding phase of evaluation, the questionnaire used was developed by studying authors exclusively related to the ERs/ISAM guidelines and manufacturer device specifications. The primary outcome was the total number of correct answers before and after the training sessions. Chi2-statistics and Odds Ratios derived from logistic regression analysis were applied to identify factors with significant influence on knowledge and application of inhalers.
Results: We found significant differences between:
(a) the error rate of correct application and
(b) the type of inhalers (p 0.001).
The knowledge of correct inhaler application was significantly improved after the one-time training session especially in the physiotherapy group. Nevertheless, this increase was not satisfactory. The knowledge of pulmonary departments staff was different compared to other departments. Finally the following factors revealed significant influence on the outcome of the overall error rate: type of inhalator, type of medical professional (physicians, nursery staff and physiotherapists), professional experience and training sessions.
Conclusion(s): In all 3 observed medical professional groups, similar a low knowledge level concerning the correct inhalation therapy was found. In general, staff members within the pulmonary department had a better knowledge about inhalation therapy compared to non-pulmonary departments. However the overall knowledge of application, efficacy and harmful side effects was surprisingly low.
Implications: The studys outcome strongly indicates the importance of establishing a standardized approach in hospital departments including regular medical staff training to increase the accuracy of the dosage of prescribed medicines. It is crucial for physiotherapists to be confident in the correct application and inhalation technique for a great variety of inhaler devices to obtain the greatest possible therapeutic benefit for the patients with COPD.
Funding acknowledgements: no funding was made
Topic: Cardiorespiratory
Ethics approval: Ethikkommission der Stadt Wien (EK 13-235-VK Votum positiv)
All authors, affiliations and abstracts have been published as submitted.
