Nationwide population-based observational study. We aimed to investigate differences in risk factors in patients with different asthma severity and evaluate whether risk factors differed between frequent exacerbators and patients with single exacerbation. However, little is known about how risk factors are associated with exacerbation, according to asthma severity. The purpose of this review is a complete criticism of pharmacological and clinical aspects related to the use of LAMA/LABA single inhalers for the maintenance treatment of stable COPD, with particular mention to the most debated topics and future prospects in the field.Īsthma exacerbation, associated with many risks factors, can reflect management failure. Many LAMA/LABA fixed dose combinations have been licensed in different countries and the clinical use of these drugs stimulated the performance of many clinical trials. Currently the Global initiative for COPD suggests the use of long acting beta agonists (LABAs) and long acting muscarinic antagonists (LAMAs) in combination for the majority of COPD patients, thus great interest is associated with the developing of LAMA/LABA fixed combination in the maintenance treatment of stable COPD. The cornerstones of treatment are bronchodilator drugs of two different classes: beta agonists and muscarinic antagonists. Great efforts were spent in the development of drugs able to improve symptoms, quality of life, reduce exacerbations, hospitalizations and the frequency of death of patients with COPD. It can be concluded that repeated education regarding proper inhaler technique with direct demonstrations and further maintained by videos can improve the quality of life in COPD patients.Ĭhronic obstructive pulmonary disease (COPD) is a common disabling disease characterized by progressive airflow obstruction. For pMDI-type inhalers, mistake mostly happened at step “while holding breath, remove inhaler from mouth”. For DPI-type inhalers, mistake mostly happened at step “breath out gently, away from inhaler”. However, as many as 63.6% of patients still made mistakes in using inhaler even though they had been educated. This indicated that quality of life of the patients had significant improvement. Before and after delivery of repeated education, the mean CAT score showed a decrease of two points, i.e., 12.8 ± 1.3 and 10.8 ± 2.0, respectively. Assessment of proper inhaler technique was carried out using a specific checklist regarding the use of inhaler translated by the researcher. Final quality-of-life examination and assessment of inhaler technique were carried out three months after the initial examination. One month later, each patient was provided further education using less than two minutes of video sent to them online via the WhatsApp application. Each patient was given a direct verbal demonstration of the appropriate use of the inhaler. The quality of life of 22 subjects was examined using the COPD assessment test (CAT) questionnaire. This is a pre-experimental study design which was carried out prospectively at Grha Permata Ibu Hospital, Depok. Repeated education is provided using direct demonstrations to patients through educational media in the form of short videos made by the researchers for each inhaler type. This study investigates the effect of repeated education on the quality of life of COPD patients during the pandemic of COVID-19 from February to June 2020. Repeated education regarding the proper use of inhalers can reduce the error rate in inhaler-using patients and improve COPD patients’ quality of life.
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