Entries for 'inhalation therapy'
Annelies I.M. Walravens, MPharm1* Emma Walravens, MPharm1,2* Stephanie C.M. Wuyts, MPharm2,3 Sander Boudewyn, MPharm4 Kayleigh Spriet, MPharm4 Kristel De Paepe, MD4 Eline Tommelein, MPharm, PhD5
Author Affiliations
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Pharmacy Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Research Center for Digital Medicine, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Queen Elisabeth Institute, Oostduinkerke, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
*These authors contributed equally to this work.
Address correspondence to:
Emma Walravens
Laarbeeklaan 103
1090 Brussels, Belgium
Phone: +32 470 25 36 20
Email: emma.walravens@vub.be
Abstract
Background: Inhalation therapy is the cornerstone of chronic obstructive pulmonary disease (COPD) management. However, errors frequently occur since every type of inhalation device has different characteristics, complicating their use. The clinical pharmacist is an expert on these devices and can be involved in the care and education of inhaler use in patients with COPD.
Objective: The feasibility of a pharmaceutical care protocol specifically for patients with COPD in a rehabilitation hospital was assessed in a quality improvement study (mixed-methods).
Method: First, the clinical pharmacist had 6 contact moments with hospitalized patients between January and April 2022, which contained appropriateness evaluations and educational moments that were focused on inhalation techniques. Subsequently, a focus group discussion with all involved health care professionals (HCPs) took place to evaluate the preliminary results of the protocol’s implementation.
Results: A total of 19 patients entered the study with the protocol resulting in a decrease of critical device errors (38.5% at baseline, to 7.7% at discharge). The HCPs concluded that it was feasible to implement the protocol given certain adjustments. A multidisciplinary collaboration between pharmacists and nurses is necessary to permit the practical implementation, as well as an individualization of the protocol based on the patient’s needs. In patient follow-up, transmural care is essential including the HCPs in primary care, and the outpatient clinic.
Conclusion: The evaluation of the protocol by the involved HCPs emphasizes the importance of a clinical pharmacist in the care of patients with COPD as part of the multidisciplinary team, not only in the community or in an acute hospital setting, but also in a rehabilitation hospital.
Citation
Citation: Walravens A, Walravens E, Wuyts S, et al. Inhalation innovation: optimizing COPD care through clinical pharmacist integration in a rehabilitation hospital's multidisciplinary team – a quality improvement study. J COPD F. 2025; 12(3): 240-249. doi: http://doi.org/10.15326/jcopdf.12.3.2024.0569
Alexander G. Duarte, MD1 Leon Tung, MD1 Wei Zhang, MS1 En Shuo Hsu, MA2 Yong-Fang Kuo, PhD2,3 Gulshan Sharma, MD, MPH1,3
Author Affiliations
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston
- Office of Biostatistics, University of Texas Medical Branch, Galveston
- Sealy Center of Aging, University of Texas Medical Branch, Galveston
Address correspondence to:
Alexander G. Duarte, MD
Division of Pulmonary, Critical Care and Sleep Medicine
University of Texas Medical Branch
301 University Blvd., 5.140 John Sealy Annex
Galveston, Texas 77555-0561
Email: aduarte@utmb.edu
Abstract
Objectives: Determine the prevalence of suboptimal peak inspiratory flow rate (PIFR) and associated patient characteristics and compare PIFR measurements obtained with spirometry and In-Check DIAL® device in ambulatory patients with COPD.
Methods: Patients underwent PIFR measurement with In-Check DIAL® device and pulmonary function testing with calibrated equipment. Group characteristics and lung function were compared for patients with suboptimal (≤ 60 L/min) and optimal (> 60 L/min) PIFR. Receiver operating curve analysis determined the best maximal forced inspiratory flow (FIF max) value in identifying optimal PIFR by gender and height.
Results: From July 1, 2016 to January 31, 2018, a total of 303 patients with chronic obstructive pulmonary disease (COPD) had PIFR and pulmonary function measurements. Group mean age was 65.5 ± 11.3 years with equal gender distribution. Suboptimal PIFR was observed in 61 (20.1%) patients. A significant correlation was observed between PIFR and FIF max, inspiratory capacity and residual volume (RV) to total lung capacity (TLC) ratio.
In the suboptimal PIFR group, mean FIF max measured by spirometry was significantly less compared with the optimal PIFR group; 178.5 ± 56.9 L/min and 263.4 ± 89.9 L/min, respectively (p<0.0001). Receiver operator curve analysis of FIF max to identify an optimal PIFR yielded an area under the curve of 0.79. Males < 65 inches had a suboptimal PIFR in 16.7 % of the male cohort, while females < 65 inches had a suboptimal PIFR in 27.4 % of the women.
Conclusions: Suboptimal PIFR was present in 1 in 5 stable patients with COPD and was more frequent in short statured females. Spirometry determined FIF max was associated with PIFR based on gender and height.
Citation
Citation: Duarte AD, Tung L, Zhang W, Hsu ES, Kuo Y-F, Sharma G. Spirometry measurement of peak inspiratory flow identifies suboptimal use of dry powder inhalers in ambulatory patients with COPD. J COPD F. 2019; 6(3): 246-255. doi: http://doi.org/10.15326/jcopdf.6.3.2018.0163
Nicola A. Hanania, MD, MS1 Sidney Braman, MD2 Sandra G. Adams, MD, MS3,4 Ruth Adewuya, MD5 Arzu Ari, PhD6 JoAnn Brooks, PhD7 Donald A. Mahler, MD8 Jill A. Ohar, MD9 Jay Peters, MD3 Shahin Sanjar, PhD10
Author Affiliations
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas
- Icahn School of Medicine at Mount Sinai, New York, New York
- University of Texas Health Science Center, San Antonio
- South Texas Veterans Health Care System, San Antonio
- American College of Chest Physicians, Glenview, Illinois
- Texas State University, San Marcos
- Indiana University Health, Bloomington
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Wake Forest Health University Medical Center, Winston-Salem, North Carolina
- Sunovion Pharmaceuticals Inc., Marlborough, Massachusetts
Address correspondence to:
Nicola A. Hanania, MD, MS
Baylor College of Medicine
1504 Taub Loop
Houston, TX 77030
E-mail: hanania@bcm.edu
Phone: 713-873-3454
Abstract
Background: Inhaled medications form the foundation of pharmacologic treatment for chronic obstructive pulmonary disease (COPD).The Delivery Makes a Difference (DMaD) project was conducted to better understand health care provider (HCP) and patient perspectives about the role of inhalation delivery devices in COPD, and to examine the nature of educational efforts between HCPs and patients on proper device technique.
Methods: Data were derived from 2 original quantitative, web-based, descriptive, cross-sectional surveys distributed to HCPs who manage COPD (n=513) and patients with COPD (n=499) in the United States. Descriptive statistics were used to assess data across important demographic variables. Inferential statistics were used to assess differences in attitudinal, descriptive, and behavioral measures that were cross-tabulated with demographic data.
Results: When prescribing medication for newly diagnosed patients with stable or unstable COPD, only 37% of HCPs considered type of device to be highly important, with only 45% of HCPs assessing device technique in every newly diagnosed patient. Patients with COPD were also relatively unconcerned with proper device technique (64% never concerned), regardless of their COPD severity. Although patients did not identify education as a significant impediment to proper device use, they reported inconsistent educational experiences.
Conclusions: We found that HCPs and patients prioritize medication over device when selecting treatments, showing limited concerns about proper device use. These results highlight the need to coordinate professional education with patient-directed educational efforts to further promote proper device selection and use in COPD management.
Citation
Citation: Hanania NA, Braman S, Adams SG, et al. The role of inhalation delivery devices in COPD: Perspectives of patients and health care providers. J COPD F. 2018; 5(2): 111-123. doi: http://doi.org/10.15326/jcopdf.5.2.2017.0168