The Impact of Technical Skills and Education on Exacerbations, Adherence to Treatment and the Choice of Inhaler Device in Patients with COPD

Abstract

Abstract Introduction. The largest challenge for patients with COPD is the correct use of inhaler devices. In COPD, inhalation therapy has a key role in symptom control, reducing the exacerbation rate, hospitalization and improving the quality of life. Choosing the active substance(s) administered by inhaler devices is an easy task because of the Gold guideline recommendations, but, when it comes to choosing the inhaler device, it is much more difficult to get recommendations. Methods. Our analysis included 200 subjects divided into two groups and its objective was the identification of some mechanisms that connect education, exacerbation and adherence to treatment, placed in the context of measuring technical skills and patients` preference for a particular inhaler device. All subjects included in the analysis were subjected to a technical skills test that included a set of 10 questions with a 30-minute solving time. The subjects in the working group were put in the position of deciding factor for the choice of an inhaler device, and implicitly for the treatment they would follow during monitoring. Results. In both groups, the lowest treatment dropout rate at T12 was recorded among those with higher levels of education, while those with poor education levels recorded very high dropout rates. In both groups we noticed that, as the level of education increased, technical skills were also increasingly better. Both in the control group and in the working group, dropout subjects at T12 had significantly lower technical skills compared to subjects who did not drop out. The level of technical skills was significantly lower in both groups in subjects with exacerbations. Statistical analysis proved the relationship between the low level of technical skills and exacerbation. The subjects with lower technical skills proved to be more prone to dropout of inhaler therapy as well. The proportion of subjects with exacerbations in the control group was significantly higher than the proportion of those with exacerbations in the work group. The proportion of subjects with exacerbations in the control group was significantly higher than the proportion of those with exacerbations in the work group. Conclusions. The authors consider that the involvement of the patient in choosing the inhaler device had a positive impact on disease control and reducing the rate of exacerbations.