الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 101 |  |  |
| | | from | 101 | | |
Abstract
In This Thesis, Adult Asthmatics (N = 221), Using A Pmdi, Were Randomly Divided Into A Verbal Training group (N = 110) And An Advanced Training group (N = 111). 21 Subjects Were Lost During The Study; Each group Included 100 Subjects At The End Of The Study. 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 Training Device And Related Smartphone Application (Clip-Tone) To The Conventional Counseling For Asthmatic Patients, Along With Detecting The Common Mistakes Of Use Of The MDI Devices And The Effect On Various Lung Function Tests And Asthma Control Test.
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) And Forced Expiratory Volume In One Second (FEV1).
• Checking The Technique Of The Inhalation Devices, Detecting The Committed Mistakes Followed By Correction Of Them.
• Asthma Control Test And from Which Asthma Control Score Is Generated.
• Using The Training Devices Clip-Tone And Related Application Clip-Tone Buddy.
Traditional Pmdi Training Was Delivered At Visit 1 To Both Groups Which Included An Explanation Of The Steps With Special Stress On Frequently Mistaken Steps E.G. Exhalation Before Use And Inhaling Slowly And Deeply. The Advanced Training group Was Advanced By Using The Clip-Tone Training Aid Linked To Its Dedicated Smartphone App. Advanced Training Patients Were Encouraged To Use This Connected Training Aid During Real-Life Use Between The Study Visits. Baseline Data Were Collected At The First Visit. At All Three Visits (Baseline, 1 Month, And 2 Months), Subjects First Completed All Inhaler Techniques, Health Outcome Measures, Received Inhaler Training, Then Took Bronchodilators, And 30 Min Later Repeated The Lung Function Outcome Measures.
Both Groups Showed A Significant Decrease (P < 0.001) In The Total Mean Number Of Pmdi Inhalation Techniques Mistakes At Visits 2 And 3, With A Lower Number Of Mistakes (P < 0.05) For Slower Inhalations For The Advanced Training group Compared To The Verbal Training Group. Inhalation Time (An Indicator Of A Slow Inhalation) Significantly (P < 0.05) Improved At Each Visit In The Advanced Training Group. In The Advanced Training Group, There Was A Gradual Significant Increase (P < 0.05) In Lung Functions While The Improvements In The Verbal Training group Were Only Significant (P < 0.05) At Visit 3, And By Visit 3, The Advanced Training group Had Significantly Higher Scores Than The Verbal Training group On Both FEV1 And PEF% Predicted. The Asthma Control Test (ACT) Score Improved At Each Visit In Both Groups With A Greater Increase In The Advanced Training group (P < 0.05) And More Patients (44 And 21) Improved Their Score By 3 Or More In The Second And Third Visit Respectively.
Conclusions
The Connected Clip-Tone Training Aid Helped Patients Improve Their Pmdi Inhaler Technique And Their Asthma Control Compared To Traditional Methods.
Exhale First, A Slow Inhalation Flow, And A Breath-Hold When Using A Pmdi Are Clinically Important And It Is Essential To Shake The Inhaler To Ensure Even Distribution Of The Dose In The Canister Before Actuating The Pmdi. This Study Shows The Value Of Providing Regular Technique Training Which Was Better When A Connected Training Aid Was Used.
Inhaling Rapidly Is The Most Common Error Made By Patients When They Use Their Pmdi. Using A Connected Training Aid During Routine Use Helps Patients To Use A Slow Inhalation Flow. These Results Highlight The Potential Of Connected Inhalers In The Future Management Of Inhaled Therapy.