OPTIMIZING INHALER TECHNIQUES IN ASTHMATIC ADULTS: A QUALITY IMPROVEMENT

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Asthma affects 4.3 million of UK adults. Long-term inhaled therapies are the mainstay management (1). Latest evidence suggests that control is rarely optimized in practice with poor inhaler technique as a prominent contributor (2-4). Currently there no routine practices to optimize asthmatic adults presenting non-asthma related illness our hospital. We developed quality improvement project techniques patients during their acute admission. METHODS: Admitted diagnosis asthma, at least on one inhaler, were identified via electronic records by lead pharmacist over an eight week period. To standardize assessment process, proforma was containing seven basic steps pertinent all inhalers per Inhaler Group’s competency document. (5)Patients’ checked doctor or senior medical student. Corrections made necessary meet agreed gold-standard criteria. Re-assessment for recall education these then carried out maximum 48 hours. RESULTS: Forty originally assessed period thirty-one being re-assessed within Nine lost follow up due unexpected hour discharge.On average each patient two different Ventolin (Salbutamol) Fostair (Beclomethasone) most frequently prescribed. On initial assessment, completed errors which contrast only self-identifying “suboptimal” prior review. Five used adjunct devices (aero-chamber Volumatic) nine had co-morbidity adversely affected techniques, such mild severe dementia, disabling stroke poorly-controlled arthritis. Prior intervention, 2.3 missed patient. The commonly (not preparing device), six holding breath 10 seconds after delivering dose) waiting few before attempting second dose). re-assessment, reduction 1.1 points Post achieved thoroughly three not having any recollection consultations. CONCLUSIONS: Incorrect use unacceptably high cohort inversely low self-awareness this fact patients. A variety reasons could account incorrect medications, including receiving little advice time initiation therapy community, instructed busy clinic specialist clinician (with less attention plan up) lack recent date technique.Careful instruction, observation taught frequent show overall medications Larger studies longer needed formally agree universal action sustained improvement. CLINICAL IMPLICATIONS: Non-asthma illnesses requiring hospital admission be considered useful screening opportunity identify potentially rectify adherence correct asthma. DISCLOSURES: No relevant relationships Joseph Hanna, source=Web Response Koushan Kouranloo, Alice Rafferty, Stephen Scott,