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ASTHMA

Influence of an Interactive Computer-Based Inhaler Technique Tutorial on Patient Knowledge and Inhaler Technique

College of Pharmacy, University of Michigan, Ann Arbor, MI

Hiral Patel, Pharmacy Student

College of Pharmacy, University of Michigan

Cary E Johnson, PharmD

Professor, College of Pharmacy, University of Michigan

Ann Durance, RN CNII

Coordinator, Asthma Airway Clinic, University of Michigan

Marc McMorris, MD

Associate Professor, Division of Allergy and Immunology, University of Michigan

William Bria, MD

Adjunct Clinical Associate Professor, University of Michigan

Steven R Erickson, PharmD

Associate Professor, College of Pharmacy, University of Michigan

Reprints: Dr. Erickson, College of Pharmacy, University of Michigan, 428 Church St., Ann Arbor, MI 48109, fax 734/763-2022, serick{at}umich.edu

BACKGROUND: Patient knowledge of correct inhaler technique is essential in the treatment of pulmonary disease. Computer delivery of educational content may augment existing teaching efforts.

OBJECTIVE: To determine whether a computer-based tutorial on inhaler technique could improve patients' knowledge and ability to correctly demonstrate inhaler technique.

METHODS: A total of 34 adults with pulmonary disease and experience using inhalers were randomized into the control or intervention groups. The intervention group viewed the tutorial, after which they demonstrated their inhaler technique and completed an Inhaler Technique Knowledge Test. Control group patients, who did not view the tutorial, were also evaluated on their demonstrated inhaler technique and technique knowledge. Additional information obtained included demographics, illness and treatment history, and patients' use of computers. Lastly, all patients who viewed the tutorial completed a brief questionnaire eliciting tutorial feedback. Control group patients were invited to view the tutorial after other data collection was complete. The 2 principal outcomes were the observed inhaler technique score and the inhaler technique knowledge test score. Comparisons between groups were conducted using Student's t-test and ² test, with a p value less than 0.05 considered statistically significant.

RESULTS: Eighteen subjects were enrolled in the computer group; 16 were in the control group. The intervention group demonstrated significantly better inhaler technique, with a mean Observed Inhaler Technique Score of 88.3 ± 12.3 compared with 67.4 ± 19.2 for the control group (p = 0.001). The intervention group also scored significantly higher on the Inhaler Technique Knowledge Test, with a score of 80.9 ± 17.0 versus 67.4 ± 11.8 for the control group (p = 0.01). Overall, the program appeared acceptable to patients.

CONCLUSIONS: Patients in the tutorial group demonstrated better inhaler technique and scored higher on the Inhaler Technique Knowledge Test compared with those in a control group. This tutorial may be a useful educational tool to enhance patient education regarding inhaler technique.

Key Words: inhaler, patient education, pulmonary disease

Published Online, February 6, 2007. www.theannals.com, DOI 10.1345/aph.1H256