الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
In This Thesis, A Number Of 390 (209 Females) Asthmatic Patients (Adults Over 18 Years-Old) Were Recruited from Outpatient Clinics Of Beni- Suef University Hospital. They Were Divided Into Three Age Groups In Two Studies For Both MDI And DPI Users. All Patients Were Subjected To Three Investigational Visits Each Separated By One Month. The Aim Of The Study Was To Investigate The Role Of Adding A Placebo-Training Device Of MDI And DPI To The Conventional Counseling For Asthmatic Patients, Along With Detecting The Common Mistakes Of Use Of The MDI And DPI Devices And The Effect On Various Lung Function Scores. All Patients Were Assessed On Basis Of:
• Use Of A Hand-Held Spirometer To Examine Their Pulmonary Functions, The Data Assessed Were Peak Expiratory Flow (PEF), Forced Expiratory Volume In One Second (FEV1) And FEV1/FVC % ( The Percentage Of Forced Expiratory Volume In One Second To Forced Vital Capacity).
• Checking The Technique Of The Inhalation Devices (MDI Or DPI), Detecting The Committed Mistakes Followed By Correction Of Them.
• Using The Training Devices Train-Haler Or Incheck-Dial Properly.
group I (Patients Using Mdis): A Number Of 304 Asthmatic Patients, Were Divided As The Following 43 ( 20 Females) Asthmatic Subjects Were Recruited In The Control group And 261 (145 Females) In The Investigation group With Mean (SD) Age 48.7 (17.2) And 49.2 (16.4) Respectively Have Completed The Study. The Patients Were Classified And Divided Into 3 Groups On Age Basis And Their Results Were Evaluated As The Following: The Analysis Has Not Shown Any Significant Difference Neither In The PEF, FEV1/FVC Percentage Nor In The Mean Number Of Mistakes Related To MDI Inhalation Technique Of Use Between Different Genders. The Increase Noticed Inboth The PEF And FEV1/FVC % And The Decline Shown Regarding The Mean Number Of Errors In The Investigated Patients Was Clearly Significant from Visit 1 To 2 (P<0.05) And Also from 1 To 3 (P<0.05). The Pulmonary Functions Test (Pfts) Results In The Investigated Patients Were Promising In Comparison To The Control Patients. There Is No Doubt That The Train-Haler Device Offered A Better And Quicker Patients’ Comprehension And Education, Yielding A Quicker Improvement In PFT Value At The Second Visit For The (Training Device Combined Verbal Counseling), Whilst The Control Patients Reached Similar Results At The Third Visit. Confronting A High Number Of Errors In Coordination Between Actuation Of The MDI Device And Slow Breathing Process (Steps Six And Seven), Which Are Considered As Common Mistakes For An MDI User, Were Noticed At The First Visit. But With Much More Learning Of Asthmatic Patients About Using The Trainhaler-Device Training Device, These Steps Were Shown To Be Easily Learned By All Age Groups When Compared With The Conventional Way Of Counseling In Both The Control Patients And Other Previous Studies Applying That Way Of Verbal Counseling Technique Solely. Hence, Verbal Counseling Using The Training Device Along With The Conventional Verbal Counseling Is A Far More Superior Technique And Has Yielded An Excellent Response Addressing The Entire Inhalation Technique, Especially In Case Of Complete Filling Up Lungs With The Inhaled Drug. Moreover, The Decline In The Mean Number Of Errors In Control Patients Was Significant Between Visit 1 And 2 (P<0.05) And from Visit 1 To 3(P<0.05). However, The Overall Improvement Of PEF And FEV1/FVC % Values Of Pulmonary Functions In Control group Was Shown To Be Only Significant from The First Visit To The Third One (The Significant Change Has Occurred At The Last Visit Only (P<0.05).
group II (Patient Using Dpis): A Number Of 86 Asthmatic Patients, Were Divided As The Following 29 (14 Females) Asthmatic Subjects Were Recruited In The Control group And 57 (30 Females) In The Investigation group With Mean (SD) Age 47.3 (16.9) And 49.9 (17.8) Respectively Have Completed The Study. The Patients Were Classified And Divided Into 3 Groups On Age Basis And Their Results Were Evaluated As The Following: The Analysis Has Not Shown Any Significant Difference Neither In The PEF, FEV1/FVC Percentage Nor In The Mean Number Of Mistakes Related To DPI Inhalation Technique Of Use Between Different Genders The Study Has Witnessed An Improvement In Pulmonary Functions; PEF And FEV1/FVC% Values And Also A Reduction Of Mean Number Of Mistakes: In The Investigated Group, The Pulmonary Function Improvement Was Clear And Significant from Visit 1 To 2 (P<0.05) And Visit 1 To 3 (P<0.05). Moreover, The Reduction In Mean Number Of Mistakes Of The Control Patients Was Significant from Visit 1 To 2 (P<0.05) And Visit 1 To 3 (P<0.001). However, The Significant Improvement Observed In Terms Of The Pulmonary Functions (PEF And FEV1/FVC% In Control Subjects Was Only Noticed from Visit 1 To 3) At (P<0.05). Furthermore, The PEF And FEV1/FCV Values In Various Age Groups Of Both The Control And Investigated Patients During Each Visit Were Significantly Higher In The Age group 1 Than Of The Other Two Age Groups (P<0.05). That May Be Attributed To The Aging Factor As The Physiological Deterioration Of Lung Functions Is Increased With Aging. However, In Previous Studies And The Control Patients (Step Six “ To Ensure A Fast, Deep Inhalation” And Step Seven “ To Ensurethe Fast Inhalation Rate Till Filling The Lungs Completely ”) Were Shown Tobe Difficult Steps To Be Achieved Only By Verbal Counseling. On The Contrary, In This Study A Much More Promising Progress Was Noticed In All Patients Of Different Age Groups In The Investigated Patients Was Noticed As Higher Percentages Of Correct Applying Of Steps Six And Seven In Both Visits Two And Three Were Noticed In Patients Using The Training Device (In-Check DIAL) Which In Turn Suggests A Useful Role Of The In-Check DIAL Device In Applying Such Crucial Steps.
Conclusions: Counselling And Using Training Devices Is Very Significant To Any Asthmatic Patient Who Uses Inhalation Devices To Eliminate Errors Of Use, Improve Medication Efficacy, And Pulmonary Functions.