Inhaler technique training: time for a re-think? (ID 442)
University of Hertfordshire
Funding: None
Abstract
Situation:Many patients make inhaler technique errors, across all types of inhalers. Some receive clinic training, but many will require re-training(1). Guidelines call for training at every opportunity(2). Google Scholar lists over 430 “inhaler technique training” retrievals but only 32 for “inhaler technique learning”. A UoH project is seeking to establish the extent of Educational Theory applied to inhaler skills development. Fleming & Mills VARK Educational Theory focuses on individual learning styles (visual (V), aural (A), reading (R), kinesthetic (K), or a mix thereof) additionally reinforcement (RF positive or negative), feedback (F) and continuous (C) guidance, can all help to develop skills.
Method:
An audit of inhaler technique training tools was conducted to categorise each tool in respect of learning features. Tools assessed included; Patient Instruction Leaflet (PIL), Placebo, Whistle Trainer, Valved Holding Chambers (VHC), In-Check DIAL (ICD) and Digital/connected inhalers (DCI).
Results:
Tool categorisation (* denotes some varieties); PIL = R, Placebo = K, RF, Whistle Trainer = A, K*, RF+, F, C*, VHC = A*, RF-*, ICD = K, F, DCI = V, A*, K, RF+*, F, C*.
Conclusion:
Inhaler technique training has focused on provision of training with less attention to the development of patient learning. Different tools engage different learning styles and individuals differ in their preferred styles. Tools employing multiple VARK modalities, positive reinforcement and continuous day to day guidance have the most options for engaging a wider group of patients.
1. Bosnic-Anticevich S, Bender B, Shuler M, Hess M, Kocks J. Recognizing and tackling inhaler technique decay in asthma and COPD clinical practice. The Journal of Allergy and Clinical Immunology: In Practice [Internet]. 2023 May 3
2. Overview | Asthma: diagnosis, monitoring and chronic asthma management | Guidance | NICE [Internet]. NICE; 2017
Conflicts of interest: None
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