Instruction of hospitalized patients by respiratory therapists on metered-dose inhaler use leads to decrease in patient errors.

BACKGROUND Hospitalized patients have been shown to make several errors in using metered-dose inhalers (MDIs), which can lead to poor medication delivery. METHODS This study was designed to look at the potential benefit of a respiratory therapist (RT) giving instruction on the use of MDIs to hospitalized patients with obstructive lung disease. A baseline group of 58 patients was observed by a physician while performing 2 actuations of their MDI and the number of errors they committed, based on the National Institutes of Health's recommended 8 steps for proper MDI use, was recorded. After a program of MDI instruction (which included encouragement to use a spacer) by an RT was performed, a second group of hospitalized patients was again observed by a physician to determine if their error rate was reduced. RESULTS The baseline error rate was 6.72 (out of 15 possible) errors per patient, and improved to 2.43 errors per patient after RT-provided instruction (p < 0.001). This improvement was still significant after controlling for an increased use of spacers in the post-instruction group of patients (27.6% and 91.7% spacer use before and after education). CONCLUSIONS Instruction of hospitalized patients with obstructive lung disease by an RT improves their correct use of MDIs and increases their use of spacers while in the hospital.