RESEARCH ARTICLE: Hands-on training on inhaled devices to boost pharmacy students’ performance during inhaler counselling
DOI:
https://doi.org/10.46542/pe.2021.211.390396Keywords:
inhaler techniques, OSCE, pharmacy curriculumAbstract
Objective: The effective use of inhalers depends on completeness of information from healthcare providers. As pharmacists acquire foundational skills on inhalers from their undergraduate curriculum, the experience and performance of pharmacy students regarding inhaler counselling should be explored.
Methods: Pharmacy students who completed their final year of study answered an online questionnaire on their experience with teaching-learning activities on inhalers. Students also underwent an objective structured clinical exam that included Turbuhaler device counselling.
Results: 84 students who completed the online questionnaire strongly agreed that the curriculum increased their awareness of different types of inhalers (65.5%) and specific techniques for use (64.3%). Students reported being able to counsel on metered-dose inhaler (98.8%) and dry-powder inhaler (92.8%) techniques. Students performed well (M=9.4, SD=2.7) at Turbuhaler counselling from a full score of 14.
Conclusions: The current training on inhaler devices was useful for the pharmacy students. Future training should emphasise supplementary advice on inhaler taste and gargling.
References
Awaisu, A., Mohamed, M. H. N., & Al-Efan, Q. A. M. (2007). Perception of pharmacy students in Malaysia on the use of objective structured clinical examinations to evaluate competence. American Journal of Pharmaceutical Education, 71(6), 118. https://doi.org/10.5688/aj7106118
Basheti, I. A. (2014). The effect of using simulation for training pharmacy students on correct device technique. American Journal of Pharmaceutical Education, 78(10), 1–10. https://doi.org/10.5688/ajpe7810177
Basheti, I. A., Bosnic-Anticevich, S. Z., Armour, C. L., & Reddel, H. K. (2014). Checklists for powder inhaler technique: A review and recommendations. Respiratory Care, 59(7), 1140–1154. https://doi.org/10.4187/respcare.02342
Basheti, I. A., Qunaibi, E. A., Hamadi, S. A., & Reddel, H. K. (2014). Inhaler technique training and healthcare professionals: Effective long-term solution for a current problem. Respiratory Care, 59(11), 1716–1725. https://doi.org/10.4187/respcare.02671
Chee, E. J. M., Prabhakaran, L., Neo, L. P., Carpio, G. A. C., Tan, A. J. Q., Lee, C. C. S., & Liaw, S. Y. (2019). Play and learn with patients-designing and evaluating a serious game to enhance nurses’ inhaler teaching techniques: A randomized controlled trial. Games for Health Journal, 8(3), 187–194. https://doi.org/10.1089/g4h.2018.0073
Chrystyn, H., Van Der Palen, J., Sharma, R., Barnes, N., Delafont, B., Mahajan, A., & Thomas, M. (2017). Device errors in asthma and COPD: Systematic literature review and meta-analysis. Npj Primary Care Respiratory Medicine, 27(1), 1–9. https://doi.org/10.1038/s41533-017-0016-z
Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2019). Current Trends and Opportunities for Competency Assessment in Pharmacy Education–A Literature Review. Pharmacy, 7(2), 67. https://doi.org/10.3390/pharmacy7020067
Fink, J. B., & Rubin, B. K. (2005). Problems with inhaler use: A call for improved clinician and patient education. Respiratory Care, 50(10), 1360–1374
Global Initiative for Asthma. Global strategy for asthma management and prevention, 2019. https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_wms.pdf
Holman, H., & Lorig, K. (2004). Patient self-management: A key to effectiveness and efficiency in care of chronic disease. Public Health Reports, 119(3), 239–243. https://doi.org/10.1016/j.phr.2004.04.002
Jeffries, P. R., & Rizzolo, M. A. (2006). Designing and implementing models for the innovative use of simulation to teach nursing care of ill adults and children : a national, multi-site , multi-method study. National League for Nursing, 1–17
Kajiwara, A., Kita, A., Saruwatari, J., Morita, K., Oniki, K., Yamamura, M., … Nakagawa, K. (2014). Absence of gargling affects topical adverse symptoms caused by inhaled corticosteroids in females. Journal of Asthma, 51(2), 221–224. https://doi.org/10.3109/02770903.2013.857683
Kane-Gill, S. L., & Smithburger, P. L. (2011). Transitioning knowledge gained from simulation to pharmacy practice. American Journal of Pharmaceutical Education, 75(10), 1–9. https://doi.org/10.5688/ajpe7510210
Lavorini, F., Magnan, A., Christophe Dubus, J., Voshaar, T., Corbetta, L., Broeders, M., … Crompton, G. K. (2008). Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respiratory Medicine, 102(4), 593–604. https://doi.org/10.1016/j.rmed.2007.11.003
Levy, M. L., Hardwell, A., McKnight, E., & Holmes, J. (2013). Asthma patients’ inability to use a pressurised metered-dose inhaler (pMDI) correctly correlates with poor asthma control as defined by the Global Initiative for Asthma (GINA) strategy: A retrospective analysis. Primary Care Respiratory Journal, 22(4), 406–411. https://doi.org/10.4104/pcrj.2013.00084
Ma, C. S., Nett, B., Kishaba, G., & Gomez, L. (2015). Impact of utilizing pharmacy students as workforce for Hawai’i Asthma Friendly Pharmacy Project. Hawai’i Journal of Medicine & Public Health : A Journal of Asia Pacific Medicine & Public Health, 74(2), 57–62
McMillan, A., & Barrickman, A. (2017). Implementation of a skills practical to first-year pharmacy students. Currents in Pharmacy Teaching and Learning, 9(6), 1111–1116. https://doi.org/10.1016/j.cptl.2017.07.024
Melani, A. S., Bonavia, M., Cilenti, V., Cinti, C., Lodi, M., Martucci, P., … Neri, M. (2011). Inhaler mishandling remains common in real life and is associated with reduced disease control. Respiratory Medicine, 105(6), 930–938. https://doi.org/10.1016/j.rmed.2011.01.005
Molimard, M., & Colthorpe, P. (2015). Inhaler devices for chronic obstructive pulmonary disease: Insights from patients and healthcare practitioners. Journal of Aerosol Medicine and Pulmonary Drug Delivery, 28(3), 219–228. https://doi.org/10.1089/jamp.2014.1142
Plaza, V., Giner, J., Rodrigo, G. J., Dolovich, M. B., & Sanchis, J. (2018). Errors in the Use of Inhalers by Health Care Professionals: A Systematic Review. Journal of Allergy and Clinical Immunology: In Practice, 6(3), 987–995. https://doi.org/10.1016/j.jaip.2017.12.032
Price, D., Bosnic-Anticevich, S., Briggs, A., Chrystyn, H., Rand, C., Scheuch, G., & Bousquet, J. (2013). Inhaler competence in asthma: Common errors, barriers to use and recommended solutions. Respiratory Medicine, 107(1), 37–46. https://doi.org/10.1016/j.rmed.2012.09.017
Rau, J. L. (2005). The inhalation of drugs: Advantages and problems. Respiratory Care, 50(3), 367–382
Rau, J. L., & Faarc, R. R. T. (2006). Practical problems with aerosol therapy in COPD. Respiratory Care. 51(2), 158– 172
Restrepo, R. D., Alvarez, M. T., Wittnebel, L. D., Sorenson, H., Wettstein, R., Vines, D. L., … Wilkins, R. L. (2008). Medication adherence issues in patients treated for COPD. International Journal of COPD, 3(3), 371–384. https://doi.org/10.2147/copd.s3036
Shirwaikar, A. (2015). Objective structured clinical examination (OSCE) in pharmacy education- A trend. Pharmacy Practice, 13(4), 1–5. https://doi.org/10.18549/PharmPract.2015.04.627
Slain, D., Abate, M., Hodges, B. M., Stamatakis, M. K., & Wolak, S. (2004). An interactive response system to promote active learning in the doctor of pharmacy curriculum. American Journal of Pharmaceutical Education, 68(5), 1–9. https://doi.org/10.5688/aj6805117
Taylor-Powell, E., & Renner, M. (2009). Collecting evaluation data : End-of-session questionnaires. University of Wisconsin-Extension, Cooperative Extension, Madison. 2009. https://cdn.shopify.com/s/files/1/0145/8808/4272/files/G3658-11.pdf. Accessed April 15, 2019
Thurmon, T. B., Schwartz, L. L., & Jervis, K. P. (2013). Asthma education in the student laboratory. Journal of Pharmacy Practice, 26(1), 29–31. https://doi.org/10.1177/0897190012466045
Toumas-Shehata, M., Henricks, M., Ovchinikova, L., Smith, L., & Bosnic-Anticevich, S. (2018). Teaching Pharmacy Undergraduate Students Inhaler Device Technique and Exploring Factors Affecting Maintenance of Technique. Canadian Respiratory Journal, 2018, 13–15. https://doi.org/10.1155/2018/1597217
Van Boven, J. F. M., Chavannes, N. H., Van Der Molen, T., Rutten-Van Mölken, M. P. M. H., Postma, M. J., & Vegter, S. (2014). Clinical and economic impact of non-adherence in COPD: A systematic review. Respiratory Medicine, 108(1), 103–113. https://doi.org/10.1016/j.rmed.2013.08.044
Volerman, A., Carpenter, D., & Press, V. G. (2020). What can be done to impact respiratory inhaler misuse: exploring the problem, reasons, and solutions. Expert Review of Respiratory Medicine, null-null. https://doi.org/10.1080/17476348.2020.1754800
Vyas, D., Wombwell, E., Russell, E., & Caligiuri, F. (2010). High-fidelity patient simulation series to supplement introductory pharmacy practice experiences. American Journal of Pharmaceutical Education, 74(9), 1–8. https://doi.org/10.5688/aj7409169
