VIDEO-TRAINING-SESSION ON METERED DOSE INHALER SKILLS AMONG INDIVIDUALS WITH COPD
Condition: Chronic Obstructive Pulmonary Disease
MeSH terms: Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
Study type: Interventional

Summary: 
      OBJECTIVE: This study was undertaken to assess the effect of repeated video-training sessions
      on the adequacy of metered-dose inhaler (MDI) among individuals with COPD.

      BACKGROUND: MDI devices facilitate the use of inhalation drugs in COPD patients and have
      become ever more important over the years. However, this device requires a certain level of
      hand-to- mouth coordination and cognitive ability. Since it has a high risk of application
      errors, training in its use is important to treatment success.

      DESIGN: Randomised controlled trial METHOD: This study was carried out from 1 February to 1
      July 2017 with the participation of 40 COPD patients. The data were collected using a
      'Patient Information Request Form' and an 'MDI Skill Evaluation Form'. CONSORT checklist was
      used to report the current study. RESULTS: It was found that there was no significant
      difference between the experimental and control groups in terms of the mean scores of the 1st
      measurement (p > .05), though the mean scores of the 5th measurement were significantly
      higher in the experimental group (p< .001). In the 5th measurement, it was identified that
      the control group had 'moderate' adequacy (3.20±1.6), while the experimental group had
      'satisfactory' adequacy (8.70 ± 1.17), indicating that the patients in the experimental group
      made fewer mistakes and showed improved adequacy.

      CONCLUSION: It was found that repeated video-training sessions materially improved MDI
      skills. Relevance to clinical practice. Supporting the training on inhaler drug therapy with
      visual technological tools and regular checking of drug use will contribute to COPD
      management.
    

Detailed description: 
      Chronic Obstructive Pulmonary Disease (COPD) -one of the most important chronic health
      problems of respiratory system- is irreversible, progresses slowly and is characterized with
      chronic inflammation and airflow obstruction (1,2,3,4). According to the report of World
      Health Organization (WHO) "Non-communicable Diseases Progress Monitor 2017"; mortality rate
      in Turkiye due to non-communicable (chronic) diseases was 88% (78.271.000 population) (5),
      over the world, 65 million people lived with moderate to severe COPD and it is estimated that
      nearly 3 million people died of COPD in 2015 (5% of all deaths) (6). Besides; COPD -one of
      the respiratory system diseases- is ranked 4th among the causes of death over the world (7)
      and it is estimated that in 2020 it will be ranked 3rd (8).

      Drug administration, an important nursing role, is a process that includes many disciplines.
      This process starts with patients' medical examination and physicians' prescription and
      includes phases of registration, observation of correct reactions and realization of the
      medical treatment by nurses, physicians, patient himself or his/her significant others (9).
      Training patients and families about treatment regime, observing patient's response to
      treatment and success of treatment are too among nurses' responsibilities (10).

      According to the studies done in literature; the study of Choi and ChoChung (2001) explored a
      positive rise in adequacy of MDI among 101 asthma patients after the MDI training session
      given, the study of Press et al. (2012) was done with 80 COPD patients about adequacy of MDI
      and 82% of the participants performed steps of MDI use wrongly before the training while 25%
      of the participants performed the same steps wrongly after the training, the study of Işık et
      al. (2014) determined mistakes in using inhaler drugs and reported that patients were unable
      to receive effective and sufficient dose of drugs and the study Özkan and Kaşıkçı (2015)
      identified mistakes in using MDI and emphasized the usefulness of the training about MDI.

      The study was planned to explore the steps where patients made mistakes while using MDI, to
      find out to what extent they used MDI correctly and to assess the effect of
      video-training-session upon adequacy of metered dose inhaler (MDI) among individuals with
      COPD.
    

Intervention name(s): VIDEO-TRAINING-SESSION ABOUT MDI USE
Intervention type(s): Other
Intervention description(s): The steps were demonstrated with the brochure that illustrated correct inhalation techniques and were prepared by Turkish Respiratory Research Society-Inhalation Treatment Study Group in line with the literature and were described with a video that was designed by Turkish National Society of Allergy and Clinical Immunology (25). The video is provided with a free access on the webpage of Turkish National Society of Allergy and Clinical Immunology.The video included images that explained the steps about what to do before MDI use, how to use the device and the issues to which attention should be paid during the use of the device and focused on the skill-steps that should gradually be performed about MDI use.
Allocation: Randomized
Intervention model: Single Group Assignment
Intervention model description: STUDY TYPE and STUDY AIM The study was experimentally undertaken in pre-test post-test control group design in order to assess the effect of video-training-session method upon adequacy of metered dose inhaler (MDI) among individuals with COPD.
STUDY POPULATION and SAMPLING In case of drop outs (wish to withdraw from the study, early hospital discharge, loss of life, etc), 20 patients were assigned to each group. The first 20 COPD patients who met the inclusion criteria were assigned to the control group whereas the second 20 COPD patients were assigned to the experimental group.
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: COPD, metered dose inhaler, training nursing, video session