Teach-to-Goal Approach May Improve Rescue Inhaler Use
A new teach-to-goal education strategy may help patients to properly use their inhalers during asthma or chronic obstructive pulmonary disease (COPD) flareups, new research has shown. Findings from the study are published in the Annals of the American Thoracic Society.
Previous data has indicated that 86% of inpatients experienced difficulty using their rescue inhalers, Valerie G. Press, MD, MPH, from the University of Chicago explained. The teach-to-goal approach proved to be an effective way of educating patients in the hospital but researchers were not sure of the long-term effects.
Dr. Press and colleagues reported on 120 patients at 2 Chicago hospitals that compared the teach-to-goal approach to a more common patient education encounter. The patient's mastery of inhaler use was assessed at the time of educational encounter and 30 and 90 days later.
Patients assigned to the teach-to-goal method learned how to use their metered-dose inhaler (MDI) through up to 3 cycles of demonstration and practice. Patients assigned to the typical instruction group were provided instructions on inhaler use that they read aloud; a healthcare professional then generally discussed their disease.
Key findings from the study include:
- MDI misuse was significantly lower in the teach-to-goal group than the brief-instruction group immediately following education session (11% vs. 60%).
- Acute-care events within 30 days of inhaler education were significantly lower in the teach-to-goal group than the brief-instruction group (17% vs. 36%).
- Acute care events within 30 days among those with low health literacy were significantly lower in the teach-to-goal group than the brief instruction group (15% vs. 70%).
- Proper use of MDIs declined overtime in both the teach-to-goal group and the brief-instruction group. At 90 days, 48% of the teach-to-goal and 76% of the brief-instruction group did not use their inhaler properly.
In a separate study (n=38) that taught patients how to properly use a Diskus inhaler, researchers found similar results when comparing the same educational strategies with MDI use. Offering teach-to-goal inhaler education in the hospital especially for those with lower health literacy, may improve overall clinical outcomes "but it also shows clearly that ongoing instruction in inhaler technique is required after discharge for long-lasting skills retention and improved health outcomes," stated Dr. Press.
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