Efficacy of an educational intervention about inhalation techniques for healthcare professionals

Clinical Research Results Abstract Introduction: Aim: To evaluate the efficacy of an educational intervention about inhalation technique in healthcare professionals to improve their patients’ technique. Methods: Pragmatic cluster randomised controlled trial. Subjects: 286 COPD (Chronic Obstructive Pulmonary Disease) patients using inhalation therapy; consecutive sampling from 20 GPs at 8 primary care centres; block randomisation. Intervention: educational and training content about the right inhalation technique for GPs leaded by a trained research team member. Patients are trained by their GP. Follow-up: 12 months. Variables (patients): correct inhalation technique (CIT), peak flow, dyspnea index, age, sex, clinical-functional status: spirometry, type/number of inhalation devices, technique training, prescribed treatment, comorbidities. Intention-to-treat analysis. Mean, percentages, 95% confidence interval. Number needed to treat (NNT); Multiple Logistic Regression. Results: Baseline: 82.9% men, mean age of 69.60 years (CI95% 68.74 – 71.04). High blood pressure 53.5%, diabetes 22.4%, osteoarthritis 32.5%. FEV1 percentage 62.14% (CI95% 59.64-64.60), predominant spirometry pattern: mixed 53.1%; severity: 23.1% mild, 50.7% moderate, 26.2% severe or more; mean peak flow 179.52 (CI95% 170.98-188.06), dyspnea index grade 2. Anticholinergic treatment 60.8%, beta2-adrenergic 87.1%, inhaled corticoids 65.7%, number of devices 2.01 (CI95% 1.91-2.11); 32.9% used Handihaler, 22.4% Accuhaler, 46.9% Turbuhaler, 19.9% Breezehaler, 37.1% pressured-metered-dose-inhaler (pMDI). 92% of patients previously trained: 31.1% demonstration with device, 43.4% explanation without device; 8.3% CIT. Intervention Effectiveness: NNT = 3.03 (CI95% 2.38-4.14). Factors associated with CIT (logistic regression 79.2% correct global classification): meaningful association with: clinical trial intervention (p<0.0001), pFEV1 (p=0.060), patient’s cognitive level (p=0.030) and dyspnea (p=0.096). Discussion: The educational intervention in inhalation techniques in GPs is effective and feasible in the context of clinical practice. A GP trained in inhalation techniques should train 3 patients in order for one of them to perform the CIT. The CIT is related to functional level of the patient as well as their cognitive level. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Authors declare no competing interest.This clinical research has great relevance in the context of strategies seeking to improve COPD patients’ use of inhalers by training their GPs and it portrays an answer to one of the most interesting questions to the IPCRG audience. There are few clinical trials were educational interventions was given directly to healthcare professionals in a primary care context. It makes sense that GPs receive good quality training and educational content, given that they are the ones who handle patients the most in everyday clinical practice.Trial Registration: ISRCTN Registry identifier ISRCTN93725230. Funding: Consejería de Salud-Bienestar Social, Junta de Andalucía (PI0170/13). References and Clinical Trial Registry Information