Gender Differences in Metered-Dose Inhaler-Spacer Device Technique
Study Objective: To determine whether gender affects the correct use of a metered-dose inhaler (MDI)-spacer device.
Design: Prospective, observational study.
Setting: University classrooms.
Patients: Eighty-three students in their third year of a Doctor of Pharmacy program.
Intervention: Students were given the device and received 20 minutes of education on its use. They then were asked to perform the technique. Assessment and retraining were done, as necessary, by clinicians who were experienced with the device. Students returned 1 week later to perform the technique again.
Measurements and Main Results: The performance of men versus women was analyzed with X tests and the Student's t test. Power analysis indicated that 30 students were needed in each group.
Conclusion: There were no significant differences between men and women in proper MDI-spacer technique.
Asthma is a disease of chronic airway inflammation and bronchial hyperresponsiveness that affects approximately 15 million Americans. Therapy consists of both oral preparations (e.g., theophyllines, leukotriene modifiers) and inhaled formulations (e.g., corticosteroids, b-agonists). Most patients prefer inhaled formulations because they deliver drug directly to the lung. In the early 1980s, a study determined the best method for using a metered-dose inhaler (MDI). The investigators found that the MDI should be actuated with a slow, deep inhalation of 25 L/minute, followed by a breath hold of 10 seconds; this produced the greatest increase in bronchodilation. Patients should shake the inhaler, exhale slowly, depress the canister and simultaneously inhale slowly over 3-5 seconds, and hold their breath for 10 seconds.
For many patients, correct technique is difficult, resulting in inadequate drug delivery to the lungs and poor disease control. Patients who are well educated about their disease and proper inhaler use have improved quality of life with decreased hospital admissions and asthma exacerbations.
A study in the mid-1990s reported that gender played a major role in proper MDI technique, with a higher proportion of men able to perform MDI maneuvers correctly. Women of all ages were less likely to show proper technique. With asthma morbidity rates higher in women, the implication that incorrect MDI use was more common in women was a concern. Based on published guidelines for correct MDI-spacer technique, we assessed whether differences exist between men and women.
Study Objective: To determine whether gender affects the correct use of a metered-dose inhaler (MDI)-spacer device.
Design: Prospective, observational study.
Setting: University classrooms.
Patients: Eighty-three students in their third year of a Doctor of Pharmacy program.
Intervention: Students were given the device and received 20 minutes of education on its use. They then were asked to perform the technique. Assessment and retraining were done, as necessary, by clinicians who were experienced with the device. Students returned 1 week later to perform the technique again.
Measurements and Main Results: The performance of men versus women was analyzed with X tests and the Student's t test. Power analysis indicated that 30 students were needed in each group.
Conclusion: There were no significant differences between men and women in proper MDI-spacer technique.
Asthma is a disease of chronic airway inflammation and bronchial hyperresponsiveness that affects approximately 15 million Americans. Therapy consists of both oral preparations (e.g., theophyllines, leukotriene modifiers) and inhaled formulations (e.g., corticosteroids, b-agonists). Most patients prefer inhaled formulations because they deliver drug directly to the lung. In the early 1980s, a study determined the best method for using a metered-dose inhaler (MDI). The investigators found that the MDI should be actuated with a slow, deep inhalation of 25 L/minute, followed by a breath hold of 10 seconds; this produced the greatest increase in bronchodilation. Patients should shake the inhaler, exhale slowly, depress the canister and simultaneously inhale slowly over 3-5 seconds, and hold their breath for 10 seconds.
For many patients, correct technique is difficult, resulting in inadequate drug delivery to the lungs and poor disease control. Patients who are well educated about their disease and proper inhaler use have improved quality of life with decreased hospital admissions and asthma exacerbations.
A study in the mid-1990s reported that gender played a major role in proper MDI technique, with a higher proportion of men able to perform MDI maneuvers correctly. Women of all ages were less likely to show proper technique. With asthma morbidity rates higher in women, the implication that incorrect MDI use was more common in women was a concern. Based on published guidelines for correct MDI-spacer technique, we assessed whether differences exist between men and women.
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