Inhaled Steroid-Dependent Asthma
Conditions
Keywords
Inhaler technique, nurse-led inhaler education, Bronchial Asthma
Brief summary
Asthma and chronic obstructive pulmonary disease (COPD) are among the most prevalent chronic respiratory conditions worldwide, affecting hundreds of millions of individuals and contributing substantially to morbidity, mortality, and healthcare burden. Although clinicians routinely advise patients verbally on inhaler use, the lack of structured, hands-on education results in significant variation in technique and consistently poor retention of skills over time.
Detailed description
Asthma and chronic obstructive pulmonary disease (COPD) are among the most prevalent chronic respiratory conditions worldwide, affecting hundreds of millions of individuals and contributing substantially to morbidity, mortality, and healthcare burden. Inhaled therapy remains the cornerstone of management for both diseases, providing targeted delivery of bronchodilators and corticosteroids while minimizing systemic side effects. Despite correct prescription of inhaler devices, a large proportion of patients demonstrate incorrect technique in inhaler use, leading to suboptimal drug delivery, poor symptom control, increased exacerbations, and frequent emergency department visits. Multiple factors contribute to this gap between prescription and real-world practice, including poor patient understanding of device mechanics, inappropriate inhalation patterns, and misconceptions about the nature and safety of inhaled corticosteroids. Although clinicians routinely advise patients verbally on inhaler use, the lack of structured, hands-on education results in significant variation in technique and consistently poor retention of skills over time. Nurses, who often maintain the most direct and sustained contact with patients, represent an underutilized resource in addressing this gap. Previous studies indicate that nurse-led inhaler education can significantly enhance practical technique, reinforce adherence, and correct misconceptions about medication use. However, there is limited evidence on the long-term retention of inhaler skills and the impact of structured nurse training on both nurse competency and patient outcomes.
Interventions
PROCEDUREInhaler technique
Patient Education: Conducted by trained nurses using standardized checklist (GINA/GOLD)
Sponsors
Mansoura University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Assess the effect of nurse-led inhaler education on patients' inhaler technique
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged ≥18 years diagnosed with Asthma or COPD according to GINA / GOLD guidelines * Current use of inhaler therapy (MDI, DPI, or Nebulizer) for ≥3 months. * Able to understand instructions and perform inhaler technique assessments. * Willing to provide informed consent and participate in all study assessments.
Exclusion criteria
* Acute exacerbation requiring hospitalization at the time of enrollment. * Cognitive impairment or neurological disorders preventing understanding or proper inhaler use. * Severe comorbidities (e.g., advanced heart failure, end-stage renal disease) that limit participation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| impact of nurse-led education on inhaler technique | 1 month | Participants will be evaluated to assess the impact of nurse-led education on technique Score: 152 This score evaluates the patient's ability to correctly use their inhaler. It covers nine key 153 components: ensuring the prescribed device type is used (MDI, DPI, or nebulizer), shaking 154 the MDI before use, complete exhalation before inhalation, proper lip seal around the 155 mouthpiece or spacer, correct inhalation speed according to device type, holding breath after 156 inhalation, rinsing the mouth after corticosteroid sprays, correct use of spacer devices, and 157 overall error correction. The maximum possible score is 9 points. Scores are interpreted as 158 follows: ≥8 indicates excellent technique, 5-7 represents moderate performance, and ≤4 159 indicates poor technique. The checklist was adapted from guideline-recommended inhaler 160 technique steps according to GINA and GOLD reports |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORMohamed AbdElmoniem
Lecturer of chest medicine faculty of medicine Mansoura university
Outcome results
None listed