Community pharmacists ʼ competence on correct inhaler techniques in Benghazi, Libya.

Authors

  • Fatma Ali Abdrabba Pharmaceutics department, Faculty of pharmacy, University of Benghazi, Libya
  • Sara S. Bouzariba Pharmaceutics department, Faculty of pharmacy, University of Benghazi, Libya
  • Hanine Karwad Pharmaceutics and industrial pharmacy department, Faculty of pharmacy, University of Benghazi, Libya.
  • and Mawada M Elshwehady Pharmaceutics and industrial pharmacy department, Faculty of pharmacy, University of Benghazi, Libya.

Keywords:

Community pharmacists, Inhaler techniques, Competence, Benghazi.

Abstract

Background:  

The inadequate use of inhaled therapy leads to poor control of asthma and chronic obstructive pulmonary disease management. Pharmacists are in the best position to educate patients about the correct use of inhalers. This study aimed to evaluate the community pharmacists’ competence on the appropriate use of inhalers in Benghazi, Libya.   

Method:

A cross sectional survey was conducted among community pharmacists from January to February 2022 in Benghazi using a self-administered questionnaire consisted of two sections: demographic data and checklists to assess the correct application of Ventolin® and Diskus® inhalers. 

Results:

This study revealed that only a small proportion of participants had previous training on the use of two devices. According to the assessment criterion of Ventolin® and Diskus® inhaler techniques, only 10.6% and 34.1% of respondents had performed all the critical steps correctly with a total score of 7 or above respectively. The least correctly demonstrated steps were step 4 of Ventolin® (tilt the head back slightly) 10.8% and step 8 of Diskus® (breathe out slowly away from the mouthpiece) 14.9%. Gender had no significant association with competence of adequate inhaler techniques of Diskus® (p-value = 0.05) and Ventolin® (p-value = 0.858). To the contrary, other variables such as work experience and previous training on inhalation techniques had influence on ability of respondents to demonstrate the correct techniques of Ventolin® with p-value = (0.003, 0.000) and  Diskus®  with p-value = (0.017, 0.000) respectively.

Conclusion:

There was poor competence among community pharmacists in using Ventolin® and Diskus® inhalers. Indicating the need for implementing regular training programs for healthcare providers particularly pharmacists to enable them educate their patients.   

References

Gregoriano, C., Dieterle, T., Breitenstein, A-L., Dürr, S., Baum, A., Maier, S., Arnet, I., Hersberger, K and Leuppi, J. (2018) Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. Respiratory Research. 19(237): 1-15.

Ozoh, O. B., Omogie, H., Obaseki, D. O., and Dosu, A. O. (2018) The competence of community pharmacists in Lagos, Nigeria, on correct inhaler techniques. Journal of Clinical Sciences. 15(4): 207-212.

Chrystyn, H. (2007) The DiskusTM: a review of its position among dry powder inhaler devices. International journal of clinical practice. 61(6): 1022-1036.

Usmani, O. S., Lavorini, F., Marshall, J., Dunlop, W. C., Heron, L., Farrington, E., and Dekhuijzen, R. (2018) Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respiratory Research. 19 (10): 1-20.

Crompton, G. K., Barnes, P. J., Broeders, M., Corrigan, C., Corbetta, L., Dekhuijzen, R., Dubus, J.C., Magnan, A., Massone, F., Sanchis, J., Viejo, J.L., and Voshaar, T. (2006) The need to improve inhalation technique in Europe: A report from the Aerosol Drug Management Improvement Team. Respiratory Medicine. 100: 1479–1494.

Basheti, I. A., Bosnic-Anticevich, S. Z., Armour, C. L., and Reddel, H. K. (2014) Checklists for Powder Inhaler Technique: A Review and Recommendations. Respiratory care. 59(7): 1140-1154.

Lavorini, F., and Usmani, O.S. (2013) Correct inhalation technique is critical in achieving good asthma control. Primary Care Respiratory Journal. 22(4): 385–386.

Melani, A.S., Bonavia, M., Cilenti, V., Cinti, C., Lodi, M., Martucci, P., Serra, M., Scichilone, N., Sestini, P., Aliani, M., and Neri, M. (2011) Inhaler mishandling remains common in real life and is associated with reduced disease control. Respiratory Medicine. 105: 930–938.

Price, D., Bosnic-Anticevich, S., Briggs, A., Chrystyn, H., Rand, C., Scheuch, G., and Bousquet, J. (2013) Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respiratory Medicine. 107: 37–46.

Belachew, S. A., Tilahun, F., Ketsela, T., Ayele, A. A., Netere, A. K., Mersha, A. G., Abebe, T. B., Gebresillassie, B. M., Tegegn, H. G., and Erku, D. A. (2017) Competence in metered dose inhaler technique among community pharmacy professionals in Gondar town, Northwest Ethiopia: Knowledge and skill gap analysis. PLOS ONE. 12(11): 1-10.

Osman, A., Ahmed, I.S, and Ibrahim, M.I. (2012) Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study. Pharmacy Practice (Granada). 10: 110‑5.

Axtell, S., Haines, S., and Fairclough, J. (2017) Effectiveness of various methods of teaching proper inhaler technique. Journal of Pharmacy Practice. 30(2): 195–201.

Hammerlein, A., Muller, U., and Schulz, M. (2011) Pharmacist-led intervention study to improve inhalation technique in asthma and COPD patients. J Eval Clin Pract. 17(1): 61–70.

Nguyen, T-S., Nguyen, T. L., Van Pham, T. T., Hua, S., Ngo, Q. C., and Li, S. C. (2018) Pharmacists’ training to improve inhaler technique of patients with COPD in Vietnam. International Journal of COPD. 13: 1863–1872.

Ali, H. D., Worku, G. S., Alemayehu, A. A., and Gebrehiwot, W. (2014) Competence in metered dose inhaler technique among dispensers in Mekelle. Allergy, Asthma and Clinical Immunology. 10(1): 1-5.

Li, H., Chen, Y., Zhang, Z., Dong, X., Zhang, G., and Zhang, H. (2014) Handling of Diskus Dry Powder Inhaler in Chinese Chronic Obstructive Pulmonary Disease Patients. Journal of Aerosol Medicine and Drug Delivery. 27(3): 219-227.

Onyedum, C., Ukwaja, K., Desalu, O., and Ezeudo, C. (2013) Challenges in the management of bronchial asthma among adults in Nigeria: A systematic review. Annual Medical Health Science Research 3: 324‑9.

Nduka, S. O., Anetoh, M. U., Amorha, K. C., Henry, O. O., and Okonta, M. J. (2016) Use of simulated patient approach to assess the community pharmacists’ knowledge of appropriate use of metered dose inhaler. Journal of Basic and Clinical Pharmacy. 7(4): 116-119.

Al-Hassan, M.I. (2009) Assessment of inhaler technique in Patients Attending a Chest Hospital in Riyadh City. International Journal of Pharmacology. 5 (3): 232–235.

Khan, T. M., and Azhar, S. (2013) A study investigating the community pharmacist knowledge about the appropriate use of inhaler, Eastern Region AlAhsa, Saudi Arabia. Saudi Pharmaceutical Journal. 21: 153–157.

Adnan, M., Karim, S., Khan, S., and Al‑Wabel, N.A. (2015) Comparative evaluation of metered‑dose inhaler technique demonstration among community pharmacists in Al Qassim and Al‑Ahsa region, Saudi‑Arabia. Saudi Pharmaceutical Journal. 23: 138‑42.

Basheti, I. A., Qunaibi, E., Bosnic-Anticevich, S. Z., Armour, C. L., Khater, S., Omar, M., and Reddel, H. K. (2011) User error with Diskus and Turbuhaler by asthma patients and pharmacists in Jordan and Australia. Respiratory Care. 56(12): 1916 -1923.

Sawsan, A.B., Kassim, A.A., Elizabet, A., Yolande, I.H., and Aqeela, M.T. (2001) Metered-dose inhaler technique among healthcare providers practicing in Oman. Journal for Scientific Research-Medical Sciences. 1: 39–43.

Baverstock, M., Woodhall, N., and Maarman, V. (2010) Do healthcare professionals have sufficient knowledge of inhaler techniques in order to educate their patients effectively in their use?. Thorax. 65(4): A117-A118.

Van Gemert, F., Vander Molen, T., Jones, R., and Chavannes, N. (2011) The impact of asthma and COPD in sub-Saharan Africa. Primary Care Respiratory Journal. 20: 240–248.

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Published

2024-03-15

How to Cite

Abdrabba, F. A., Bouzariba, S. S., Karwad, H., & Elshwehady, and M. M. (2024). Community pharmacists ʼ competence on correct inhaler techniques in Benghazi, Libya. Academic Journal of Science and Technology, 2(1), 136–142. Retrieved from https://ajost.journals.ly/ojs/index.php/1/article/view/47