The Effect of İnhaler Training and Reminders on Medication on Adherence in Elderly Individuals

Official title

The Effect Of Metered-Dose İnhaler Training And Reminders On Medication Adherence In Elderly Individuals: A Randomized Controlled Study

Overview

This study will evaluate the effect of metered-dose inhaler training and reminders on treatment adherence in elderly individuals.

Detailed description

The presence of multiple comorbidities and an increased number of medications in elderly individuals are significant risk factors for non-adherence to inhaler therapy. Forgetfulness, lack of confidence in medications and difficulty understanding how to take them, depression, low self-efficacy, disease severity, and disease perception can all affect adherence to treatment. Incorrect inhaler use can lead to patients receiving insufficient medication, increased symptom burden, and negatively impact their quality of life. Furthermore, incorrect inhaler technique has been shown to increase the risk of hospitalization, emergency room visits, and the use of antibiotics and oral corticosteroids. Implementing procedures to ensure correct inhaler use is crucial in controlling critical errors in inhaler therapy. Elderly patients are more likely to have conditions such as arthritis that affect physical movement and coordination. Cognitive function also affects the ability to use inhaler devices correctly. It is known that incorrect inhaler use is more common, particularly in untrained and elderly individuals, with frequent errors including poor hand-mouth coordination, inability to synchronize spraying and inhalation, and failure to hold the breath during inhalation being common mistakes in metered-dose inhaler use. Therefore, this study will evaluate the effect of metered-dose inhaler training and reminders on treatment adherence in elderly individuals.

Interventions

• Other Metered Dose Inhaler Training
  It is known that incorrect inhaler use is more common, especially in elderly individuals, and that common errors in metered-dose inhaler use include poor hand-mouth coordination, inability to simultaneously spray and inhale, and failure to hold the breath during inhalation. This study evaluates metered-dose inhaler use only in elderly individuals. Furthermore, not only will the inhaler application steps be evaluated, but the experimental group will also receive education and reminder interventio
• Other Metered Dose Inhaler Reminder Card
  This reminder card contains the inhaler administration steps included in the "Measured Dose Inhaler Medication Use Skill Chart". Participants in the experimental group will be able to access the medication administration steps on the reminder card before administering their inhaler medication. Participants will be asked in the final interview whether they used the reminder cards.
• Other Metered Dose Inhaler Application Video
  This video was prepared by the responsible researcher, taking into account the application steps included in the "Metered Dose Inhaler Medication Use Skill Chart". Participants in the experimental group will be able to access the application steps via the inhaler video before administering their inhaler medication.

Primary outcome measures

• Metered Dose Inhaler Skill [Time frame: the initial screening and three months after the initial screening (three months)]
• Medication Adherence Reporting Scale [Time frame: the initial screening and three months after the initial screening (three months)]

Eligibility criteria

Inclusion criteria for the study:

• Age ≥ 65 years old
• Having at least basic literacy,
• Receiving metered-dose inhaler therapy for at least 6 months,
• Being hospitalized in the pulmonary ward,
• Presenting to the pulmonary function test unit,
• Presenting to the pulmonary outpatient clinic,
• Signing the informed consent form for participation in the study,
• Having internet access and a mobile device with Android/iOS operating system,
• Being able to use a telephone,
• Having no communication barriers,
• Being able to use the inhaler without needing assistance,
• Making an error in at least one of the usage steps according to the MDI usage skills chart.

Exclusion criteria for the study:

• Age <65
• Illiteracy
• Receiving metered-dose inhaler therapy for <6 months
• Outpatient treatment
• Being hospitalized in the intensive care unit
• Being hospitalized in wards other than the pulmonary ward (such as surgery, physical therapy)
• Visiting outpatient clinics other than the pulmonary clinic (such as surgery, physical therapy)
• Not signing the informed consent form for participation in the study
• Not having internet access and a mobile device with Android/iOS operating system
• Not having telephone skills
• Having communication barriers
• Requiring assistance while using the inhaler
• Not making any errors in the usage steps according to the MDI usage skills chart
• Wanting to withdraw from the study/withdrawing from participation during the research process
• Not completing the questionnaire

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Supportive care

Study locations

Turkey (Türkiye) · 1 center

• Department of Nursing, Faculty of Health Sciences, Canakkale Onsekiz Mart University — Çanakkale

Identifiers

NCT: NCT07381166 · AIBU-SBF-SA-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗