2.50
Hdl Handle:
http://hdl.handle.net/10755/157215
Type:
Presentation
Title:
Cognitive Function, Disease State and Medication Errors in COPD Self-Therapy
Abstract:
Cognitive Function, Disease State and Medication Errors in COPD Self-Therapy
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Payment, Dale, RN, MSN, JD
P.I. Institution Name:Napa Valley College
Title:Simulation Center Coordinator
Contact Address:4225 Solana Avenue #513, Napa, CA, 94558, USA
Contact Telephone:707-253-3000X7030
Co-Authors:Paula M. Meek, RN, PhD; Paula Bittner, BSN; and Claudia Torres, RN, BSN
Specific Aims: This paper discusses the evaluation of a model addressing the impact of cognitive performance upon the use of inhaled medication for the dyspneic episodes of Chronic Obstructive Pulmonary Disease (COPD). In particular, the model inquires whether general cognitive functioning, and disease state influences a person's errors in technique while self-administering inhaled medication. Rationale and Background: Successful self-management of the dyspneic episodes of COPD requires coordinated performance of skills needed for effective metered dose inhaler (MDI) use. Predictably, research supports that an intact cognitive function is crucial for the correct self-administration of the pharmacologic agents in MDIs (Allen, Jain, Ragab, & Malik, 2003). Disturbingly, research also suggests that a relationship exists between COPD and accelerated impairment of cognitive function (Liesker et al., 2004; Meek, Lareau, & Anderson, 2001). This study investigates whether general cognitive functioning influences the effective performance of MDI use defined as technique errors. Methods: The study included 29 participants with COPD who had mild to severe (< FEV1 80 %) pulmonary impairment. The mean age of the sample was 68 and 55% were male. General cognitive performance of the participants was measured with the Mini-Mental State Examination (MMSE) and the EXIT25. The MMSE taps global cognitive function whereas, the EXIT25 assesses frontal executive function. Participant MDI technique was monitored over a four-week period with an electronic monitor (MDIlog). The MDIlog provides information on the technique of taking inhaled medications including whether: (a) the medication was shook prior to inhalation; (b) was inhaled too fast; (c) was a delay in the inhalation; or (d) multiple puffs were attempted inappropriately. Results: A hierarchical stepwise multiple regression analysis was done to explore whether general cognitive function, spirometry, and dyspnea scores predicted the error rates of participant MDI technique. Error rate of MDI technique was used as the dependent variable with the MMSE, EXIT 25, spirometry values and general dyspnea scores as independent variables. Unfortunately, this model accounted for no significant variance in participant MDI error rate (F <1.50 p > .05). Further analysis will be reported at the time of presentation.
Conclusion: The lack of significant findings draws into question what other factors may be influencing participant MDI techniques. Certain limitations of this analysis are clear, the first being sample size. Another possible limitation might be the homogeneity of the sample in age, disease profile, and educational background. Further investigation of the influence of person's general cognitive function and disease status on MDI technique is warranted given the importance of this self-treatment method in individuals with COPD.
Research reported here funded by NINR, Grant # RO1NRO1437.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCognitive Function, Disease State and Medication Errors in COPD Self-Therapyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157215-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Cognitive Function, Disease State and Medication Errors in COPD Self-Therapy</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Payment, Dale, RN, MSN, JD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Napa Valley College</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Simulation Center Coordinator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">4225 Solana Avenue #513, Napa, CA, 94558, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">707-253-3000X7030</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dpayment@napavalley.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Paula M. Meek, RN, PhD; Paula Bittner, BSN; and Claudia Torres, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Specific Aims: This paper discusses the evaluation of a model addressing the impact of cognitive performance upon the use of inhaled medication for the dyspneic episodes of Chronic Obstructive Pulmonary Disease (COPD). In particular, the model inquires whether general cognitive functioning, and disease state influences a person's errors in technique while self-administering inhaled medication. Rationale and Background: Successful self-management of the dyspneic episodes of COPD requires coordinated performance of skills needed for effective metered dose inhaler (MDI) use. Predictably, research supports that an intact cognitive function is crucial for the correct self-administration of the pharmacologic agents in MDIs (Allen, Jain, Ragab, &amp; Malik, 2003). Disturbingly, research also suggests that a relationship exists between COPD and accelerated impairment of cognitive function (Liesker et al., 2004; Meek, Lareau, &amp; Anderson, 2001). This study investigates whether general cognitive functioning influences the effective performance of MDI use defined as technique errors. Methods: The study included 29 participants with COPD who had mild to severe (&lt; FEV1 80 %) pulmonary impairment. The mean age of the sample was 68 and 55% were male. General cognitive performance of the participants was measured with the Mini-Mental State Examination (MMSE) and the EXIT25. The MMSE taps global cognitive function whereas, the EXIT25 assesses frontal executive function. Participant MDI technique was monitored over a four-week period with an electronic monitor (MDIlog). The MDIlog provides information on the technique of taking inhaled medications including whether: (a) the medication was shook prior to inhalation; (b) was inhaled too fast; (c) was a delay in the inhalation; or (d) multiple puffs were attempted inappropriately. Results: A hierarchical stepwise multiple regression analysis was done to explore whether general cognitive function, spirometry, and dyspnea scores predicted the error rates of participant MDI technique. Error rate of MDI technique was used as the dependent variable with the MMSE, EXIT 25, spirometry values and general dyspnea scores as independent variables. Unfortunately, this model accounted for no significant variance in participant MDI error rate (F &lt;1.50 p &gt; .05). Further analysis will be reported at the time of presentation. <br/>Conclusion: The lack of significant findings draws into question what other factors may be influencing participant MDI techniques. Certain limitations of this analysis are clear, the first being sample size. Another possible limitation might be the homogeneity of the sample in age, disease profile, and educational background. Further investigation of the influence of person's general cognitive function and disease status on MDI technique is warranted given the importance of this self-treatment method in individuals with COPD. <br/>Research reported here funded by NINR, Grant # RO1NRO1437.</td></tr></table>en_GB
dc.date.available2011-10-26T19:40:17Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:40:17Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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