Exploring the role of quantitative feedback in inhaler technique education: a cluster-randomised, two-arm, parallel-group, repeated-measures study

Feedback is a critical component of any educational intervention. When it comes to feedback associated with inhaler technique education, there is a lack of knowledge on its role or its potential to solve the major issue of poor inhaler technique. This study aims to explore the role of feedback in inhaler technique education and its impact on the inhaler technique of patients over time. A parallel-group, repeated-measures study was conducted in the community pharmacy in which the effectiveness of current best practice inhaler technique education utilising qualitative visual feedback (Group 1) was compared with a combination of qualitative and quantitative visual feedback (Group 2). The impact of these two interventions on inhaler technique maintenance was evaluated. Community pharmacists were randomly allocated to recruit people with asthma who were using a dry powder inhaler. At Visit 1 their inhaler technique was evaluated and education delivered and they were followed up at Visit 2 (1 month later). Both educational interventions resulted in an increase in the proportion of patients with correct inhaler technique: from 4% to 51% in Group 1 and from 6% to 83% in Group 2 (Pearson’s Chi-Squared, P=0.03, n=49, and Pearson’s Chi-Squared, P=0.01, n=48, respectively). The magnitude of improvement was statistically significantly higher for Group 2 compared with Group 1 (n=97, P=0.02, Pearson’s Chi-Square test). The nature of feedback has an impact on the effectiveness of inhaler technique education with regard to correct inhaler technique maintenance over time. Combining methods to educate patients on correct inhaler use improves their technique long-term, an international research team states. Over half of asthma sufferers use their inhalers incorrectly, with many not retaining the training given at the start of treatment. Mariam Toumas-Shehata and co-workers at the University of Sydney, together with researchers in the UK and Jordan, studied two groups of patients trained by pharmacists in order to determine the best methods for improving inhaler technique. Both groups were given individual verbal feedback on technique and a physical demonstration of correct use. One group was also taught using an Inhalation Manager machine, which allowed patients to see their breathing patterns and visualize mistakes. Patients in both groups improved their inhaler technique, with significantly greater improvement in the group also taught using the Inhalation Manager.