2.50
Hdl Handle:
http://hdl.handle.net/10755/158011
Type:
Presentation
Title:
Examining Inhaled Medication Delivery and Breathing in Those With COPD
Abstract:
Examining Inhaled Medication Delivery and Breathing in Those With COPD
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Bittner, Paula, RN, BSN, MLS, MFA
P.I. Institution Name:University of New Mexico
Title:Program Manager
Contact Address:College of Nursing, MSC09 5350, 1 University of New Mexico, Albuquerque, NM, 87131, USA
Contact Telephone:505-272-4994
Co-Authors:Paula M. Meek, RN, PhD; Dale Payment, RN, MSN, JD; and Claudia Torres, RN, BSN
Specific Aims: This paper presents an analysis of daily diaries and medication monitors to evaluate the individual's use of inhaled medication and episodes of breathlessness experience as in Chronic Obstructive Pulmonary Disease (COPD). Specifically, what difficulties exist in inhaled medication delivery and how does that relate to days when breathing effort and breathing distress were alike and not alike? Rationale and Background: Strong evidence in physiology and cognitive psychology indicate that individuals, when experiencing changes in breathing, can become hypervigilant and anxious. It is clear that in a state of attention to internal cues and nervousness that medication delivery and the techniques associated with this can be less than optimal. There is a long standing problem in management of individuals with COPD that inhaled medication techniques are complicated and that frequently an ineffectual dose may be delivered. It holds then that individuals who experience an increase in breathing distress on any particular day will have greater problems with properly inhaled medication delivery, than on days when breathing distress is at a typical level. However, few studies have attempted to examine the pattern of inhaled medication technique errors in individuals with COPD or compare these patterns to times when breathing distress is up and the individual might need it most. Methods: The study included 29 individuals with COPD who were 55% male, had mild to severe (< FEV1 80 %) impairment, and were an average of 68 (+8) years age old. Metered dose inhaled (MDI) medications were monitored over a four week period with an electronic monitor (MDIlog) along with daily breathing effort and distress. The MDIlog provides information on the technique of taking inhaled medications including, whether the medication was shook prior to inhalation, was inhaled too fast, there was a delay in the inhalation or multiple puffs were attempted inappropriately. Each MDI dispense for each individual over the 4 weeks was evaluated for technique errors (n=728). The breathing effort and distress were assessed by a visual analogue scale with the ratio of distress to effort used to identify days when they were alike and not alike. Days where breathing effort and distress were alike (with 5mm) and where breathing effort was greater than distress (> 5mm) and breathing effort was less than distress were coded into three groups for ANOVA. Results: Individuals used their MDI an average of 4.6 (+5) times per day with errors in technique occurring 66% of the time. ANOVA (F=6.80, p<.01) results revealed that on days where breathing distress was greater than effort medication errors decreased (55%) while on days where there was no difference (66%) or effort was greater (69%) there were more. This pattern can be seen with specific components of the MDI delivery technique such as medication being shaken prior to inhalation (Chi square =12.17, p<.01), and when inhaling too fast (F=8.93, p<.001). Conclusion: The results support the general notion that individuals with COPD generally have poor technique when it comes to inhaled medication delivery. Also, that with periods of increased breathing distress, there is a decrease in inhaled medication delivery errors, potentially due to increase attention due to need. These medication delivery errors need to be examined further to provide cues as to how they may impact an individual's ability to carry out symptom self-management in general. Research reported here funded by NINR, Grant # RO1NR008142.
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.titleExamining Inhaled Medication Delivery and Breathing in Those With COPDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158011-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Examining Inhaled Medication Delivery and Breathing in Those With COPD</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">Bittner, Paula, RN, BSN, MLS, MFA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of New Mexico</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Program Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">College of Nursing, MSC09 5350, 1 University of New Mexico, Albuquerque, NM, 87131, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">505-272-4994</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pbittner@salud.unm.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Paula M. Meek, RN, PhD; Dale Payment, RN, MSN, JD; and Claudia Torres, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Specific Aims: This paper presents an analysis of daily diaries and medication monitors to evaluate the individual's use of inhaled medication and episodes of breathlessness experience as in Chronic Obstructive Pulmonary Disease (COPD). Specifically, what difficulties exist in inhaled medication delivery and how does that relate to days when breathing effort and breathing distress were alike and not alike? Rationale and Background: Strong evidence in physiology and cognitive psychology indicate that individuals, when experiencing changes in breathing, can become hypervigilant and anxious. It is clear that in a state of attention to internal cues and nervousness that medication delivery and the techniques associated with this can be less than optimal. There is a long standing problem in management of individuals with COPD that inhaled medication techniques are complicated and that frequently an ineffectual dose may be delivered. It holds then that individuals who experience an increase in breathing distress on any particular day will have greater problems with properly inhaled medication delivery, than on days when breathing distress is at a typical level. However, few studies have attempted to examine the pattern of inhaled medication technique errors in individuals with COPD or compare these patterns to times when breathing distress is up and the individual might need it most. Methods: The study included 29 individuals with COPD who were 55% male, had mild to severe (&lt; FEV1 80 %) impairment, and were an average of 68 (+8) years age old. Metered dose inhaled (MDI) medications were monitored over a four week period with an electronic monitor (MDIlog) along with daily breathing effort and distress. The MDIlog provides information on the technique of taking inhaled medications including, whether the medication was shook prior to inhalation, was inhaled too fast, there was a delay in the inhalation or multiple puffs were attempted inappropriately. Each MDI dispense for each individual over the 4 weeks was evaluated for technique errors (n=728). The breathing effort and distress were assessed by a visual analogue scale with the ratio of distress to effort used to identify days when they were alike and not alike. Days where breathing effort and distress were alike (with 5mm) and where breathing effort was greater than distress (&gt; 5mm) and breathing effort was less than distress were coded into three groups for ANOVA. Results: Individuals used their MDI an average of 4.6 (+5) times per day with errors in technique occurring 66% of the time. ANOVA (F=6.80, p&lt;.01) results revealed that on days where breathing distress was greater than effort medication errors decreased (55%) while on days where there was no difference (66%) or effort was greater (69%) there were more. This pattern can be seen with specific components of the MDI delivery technique such as medication being shaken prior to inhalation (Chi square =12.17, p&lt;.01), and when inhaling too fast (F=8.93, p&lt;.001). Conclusion: The results support the general notion that individuals with COPD generally have poor technique when it comes to inhaled medication delivery. Also, that with periods of increased breathing distress, there is a decrease in inhaled medication delivery errors, potentially due to increase attention due to need. These medication delivery errors need to be examined further to provide cues as to how they may impact an individual's ability to carry out symptom self-management in general. Research reported here funded by NINR, Grant # RO1NR008142.</td></tr></table>en_GB
dc.date.available2011-10-26T20:25:17Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:25:17Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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