Misused Inhaler and Insufficient Peak Inspiratory Flow in Hospitalized COPD Patients Before and After Implementation of a Systematic Assessment and a Prescription Guide - a Quasi Experimental Study - MIPIF
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 101
- 试验地点
- 2
- 主要终点
- Proportion of inhalers used sub-optimally at hospital discharge
研究概览
简要总结
The drug treatment of chronic obstructive pulmonary disease (COPD) is mainly based on inhaled therapy. This route of administration is limited by inhaler handling errors, insufficient inspiratory flow or inappropriate inhalers. According to the scientific literature, these limitations are extremely common in both outpatients and inpatients.
Our hypothesis is that the implementation of a standardised and systematic assessment of inhalers combined with a prescribing guide to help select a suitable inhaler will decrease the proportion of suboptimally used inhalers at discharge in patients hospitalised with a diagnosis of COPD.
To assess the effectiveness of our intervention, the investigators will compare the proportion of inhalers used suboptimally at hospital discharge between a control cohort before the implementation of our intervention and a cohort after the implementation of our intervention. Secondary outcomes include reasons for sub-optimal use of inhalers, i.e. inhaler handling errors, insufficient peak inspiratory flow or inappropriate inhaler. Secondary outcomes will also include length of hospital stay and 30-day readmission rate.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Admission to the HFR Fribourg internal medicine department
- •Age greater than or equal to 18 years
- •Diagnosis of COPD
- •Use of an inhaler device for the treatment of COPD before admission
排除标准
- •Inability to complete initial assessment due to language problems
- •Inability to complete initial assessment due to physical or mental conditions
- •Patient who has already received the intervention during a previous hospitalization.
- •Length of hospitalization of less than 72 hours
- •Patient already included in the control period
结局指标
主要结局
Proportion of inhalers used sub-optimally at hospital discharge
时间窗: This outcome is assessed within 48 hours prior to hospital discharge
An inhaler used sub-optimally is defined as an inhaler used with at least one critical error and/or with insufficient inspiratory flow.
次要结局
- Proportion of inappropriate inhaler at hospital discharge.(This outcome is assessed within 48 hours prior to hospital discharge)
- Proportion of inhaler used with suboptimal peak inspiratory flow at hospital discharge.(This outcome is assessed within 48 hours prior to hospital discharge)
- Proportion of inhalers used sub-optimally at hospital discharge by type of inhaler.(This outcome is assessed within 48 hours prior to hospital discharge)
- Length of hospital stay(This outcome is assessed up to three months)
- Proportion of inhaler used with a critical error at hospital discharge(This outcome is assessed within 48 hours prior to hospital discharge)
- Proportion of inhalers that cannot be handled properly despite appropriate teaching at hospital discharge.(This outcome is assessed within 48 hours prior to hospital discharge)
- Proportion of patients using at least one inhaler sub-optimally(This outcome is assessed within 48 hours prior to hospital discharge)
研究者
Gaël Grandmaison
Doctor
Hôpital Fribourgeois