Inhaler technique mastery and maintenance in general medical practitioners: Easy Low Instruction Over Time (Dr ELIOT)

This study involves an intervention that is delivered on two occasions, one month apart (at Visit 1 and Visit 2). Each visit will take no longer than ten minutes. The intervention: At Visit 1, participants are given one of two placebo inhalers and are asked to use the inhaler. If they are not able to demonstrate correct inhaler technique, they will receive education in the form of written information; if then are still not able to use the inhaler after the written information, they will be shown a video on device technique and if following this they are still not able to demonstrate correct inhaler technique they will be given individualised education by the researcher. The same will be repeated for the other device. The same process (intervention) will be delivered with the same two devices at Visit 2 (1 month after Visit 1). The intervention will be delivered by researcher assistants from the Woolcock Institute of Medical Research. The two inhalers that will be used are Turbuhalers and Spiromax inhalers. Written instructions for their use have been developed by the research team and based on product information that is available to patients. Video instructions on inhaler use that will be used are publicly available on the National Asthma Council website for health care professional and patient use. The cross over nature of the study is in reference to GPs being asked to demonstrate use of 2 devices, one after the other. In consideration of the fact that receiving instruction on the use of the first inhaler may positively influence the intuitive use of the second inhaler, GPs will be randomly allocated to use of either inhaler first to accomodate for this bias. To ensure fidelity to the intervention, GPs inhaler technique is assessed by the researchers following each level of education until inhaler technique is mastered. The Turbuhaler placebo devices are empty and contain no active ingredients. The spiromax devices contains Lactose monohydrate with approximately 10mg delivered per inhalation.