Virtual education comparable to in-person inhaler education in asthma, COPD
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New data indicate that patient-directed virtual education yielded similar improvements in inhaler technique as in-person education among patients with asthma or COPD.
In this randomized controlled, noninferiority trial, the researchers randomly assigned adults with asthma or COPD admitted to general inpatient wards to virtual or in-person educational interventions to improve inhaler technique, which was assessed using a previously validated 12-step checklist. A patient was considered to have correct inhaler technique if they performed at least 10 steps correctly.
More than three-quarters of the 118 study patients (97% black; 64% women; mean age, 54.5 years) completed the interventions within 2 to 3 days of hospitalization. Results showed that the increase in the percentage of patients with improved inhaler technique after virtual education was on par with that seen after in-person education (67% and 66%, respectively). The researchers also noted that the difference after intervention was –14% (95% CI lower bound, –26%), which exceeded the noninferiority limit of –10%. However, after adjustment for baseline inhaler technique, the difference was equivalent to –10% (95% CI lower bound, –22%).
The virtual intervention, which was delivered via a tablet device, included self-assessment questions before demonstration, narrated video demonstration of correct inhaler technique and self-assessment questions after demonstration. The narrated demonstration and self-assessment questions were repeated up to three times, as needed. The in-person education intervention consisted of up to three rounds of inhaler technique education with evaluation provided by the research educator.
Although the study suggests that virtual education may be nearly as effective as in-person education for correcting inhaler misuse among hospitalized patients, larger-scale studies are needed to examine long-term effects of such an intervention on inhaler technique skills and patient outcomes when used in other health care or home settings, according to the researchers.
“If [a virtual education intervention] is shown to be feasible and effective across diverse populations and settings, this innovation could transform the ability of health care systems and individual clinicians to deliver guideline-recommended education for inhalers effectively with the goal of improving health outcomes and avoiding exacerbations,” they wrote. – by Melissa Foster
Disclosures: Press reports she has received grants from the NIH, the American Thoracic Society and the American Lung Association and personal fees from the American Academy of Allergy, Asthma and Immunology, RoundGlass, the Society of Hospital Medicine and Vizient Inc. All other authors report no relevant financial disclosures.