ASSESSMENT AND BARRIERS REGARDING INHALER TECHNIQUE AMONG ADMITTED PATIENTS OF OBSTRUCTIVE LUNG DISORDERS OF PULMONOLOGY WARD

Introduction: Occupational lung diseases, COPD, and other chronic respiratory ailments including asthma are among the world's major causes of morbidity and mortality. With little information about inhaler strategies, Pakistan has a large prevalence of COPD and asthma. For efficient disease treatment, medications must be administered using pressurized metered dosage inhalers, and improper breathing technique can lead to disappointing pharmacological effects and increased consequences. As a result, the purpose of this study was to analyze the  assessment and   barriers regarding use of inhaler technique among admitted patients of obstructive lung disorders  of  pulmonology ward(a cross sectional study).

Objectives: To analyze the assessment and barriers regarding use of inhaler technique among admitted patients of obstructive lung disorders of pulmonology ward.

Methods: A mixed-methods study with an embedded design was conducted, comprising a cross-sectional quantitative survey supplemented by qualitative in-depth interviews (IDIs).The study was carried out in the Pulmonology wards of Lady Reading Hospital (LRH), Peshawar, over a period of six months in  year 2023.The study population included adult patients diagnosed with obstructive lung diseases who were using pressurized metered-dose inhalers (pMDIs). For the qualitative component, both patients and physicians involved in inhaler use and management were included. For Quantitative component, A total of 244 patients were enrolled for the cross-sectional survey and Four in-depth interviews were conducted, including two physicians and two patients, to explore perceptions and experiences in greater depth. Sampling Technique A non-probability convenient sampling technique was used for both quantitative and qualitative components. Data were collected using a semi-structured questionnaire for the quantitative survey and an in-depth interview guide for the qualitative component. Interviews were conducted to gain deeper insights into barriers, practices, and perceptions related to inhaler use. Quantitative data were analyzed descriptively, while qualitative data from IDIs were analyzed using thematic analysis, following systematic coding and theme development. Ethical Considerations were strictly observed. Confidentiality and anonymity of both patients and physicians were maintained throughout the study, and informed consent was obtained prior to participation.

Results: This study investigated inhaler use among 243 patients with obstructive respiratory disorders. The participant pool had a balanced gender distribution and a mean age of 49.3 years. The primary diagnoses were asthma (57.8%, N=141) and COPD (32.8%, N=80).Family History showed 53% (N=129) reported a family history of respiratory problems. Smoking Status were  22.1% (N=54) were smokers where as Education Level was 33.4% (N=83) were illiterate, 49.6% (N=121) had an undergraduate degree, and 16.4% (N=40) had a graduate degree.

Regarding inhaler technique and training ;78.7% (N=192) of patients received instruction on inhaler technique, mostly from nurses (61.5%, N=150) .34% (N=83) of patients utilized a spacer with their inhaler.Only two steps—removing the cap and pressing down on the canister—were correctly performed by all participants

Important results showed that poor inhaler technique was significantly correlated with older persons (51 years of age and older) ,Improper inhaler technique was more common in patients, and medication adherence was strongly correlated with technique. Counseling on inhaler technique demonstrated a strong correlation with proper use, underscoring the need of such treatments. According to physicians approximately 20% to 60% of patients attending Pulmonology OPD in LRH did so in practice.

Conclusions: Inhaler technique counselling is a highly reliable indicator of proper technique. The study emphasizes the necessity for healthcare professionals to take into account a variety of variables like age, education status, disease duration, medication adherence, proper counselling, and periodic assessment of patient when recommending inhaler devices to patients in order to facilitate obstructive lung disease patients to improve disease outcome.