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A Telemedicine Intervention to Ensure the Correct Usage of Inhaler Devices.

Authors
  • Trosini-Désert, Valery1
  • Lafoeste, Hélène1
  • Regard, Lucile1
  • Malrin, Roxane1
  • Galarza-Jimenez, Maria-Alejandra1
  • Amarilla, Cristina Esteban1
  • Delrieu, Jacqueline2
  • Fôret, Didier2
  • Melloni, Boris2
  • El-Khouari, Fadwa3
  • Similowski, Thomas1, 4
  • 1 Department of Respiratory and Intensive Care Medicine, Salpêtrière Hospital, Paris, France. , (France)
  • 2 ANTADIR Federation, Maison du Poumon, Paris, France. , (France)
  • 3 Hospital Pharmacy, Salpêtrière Hospital, Paris, France. , (France)
  • 4 Clinical and Experimental Respiratory Neurophysiology, Sorbonne University, Paris, France. , (France)
Type
Published Article
Journal
Telemedicine journal and e-health : the official journal of the American Telemedicine Association
Publication Date
Nov 01, 2020
Volume
26
Issue
11
Pages
1336–1344
Identifiers
DOI: 10.1089/tmj.2019.0246
PMID: 32302518
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Background: Chronic obstructive pulmonary disease and asthma patients' use of inhalers is error prone. Introduction: This study evaluated telemedicine to improve the use of inhalers. Materials and Methods: Prospective, single-center pilot study in 50 patients with long-term prescription of inhaled medicine and ongoing home health care visits. In an initial telemedicine intervention, tablet devices were used by the patient to record inhaler use at home in the real-time remote presence of a physician. Errors were identified, explained to the patient, and corrected remotely. When necessary, further telemedicine interventions were scheduled at 24-48 h intervals. Follow-up interventions were performed during routine outpatient visits. Patient satisfaction was evaluated on a scale of 0 (completely unsatisfied) to 10 (completely satisfied). Results: An initial telemedicine intervention was conducted for 42 of the 50 patients included. In these patients, 96 initial inhaler medicine administration telemedicine interventions were performed, of which 94 were usable. In the initial interventions, 71 errors were identified, of which 22 (31%) were considered critical. In 81 follow-up interventions in 39 patients (median delay 256 days), 32 errors were identified (p < 0.001 vs. initial 71 errors), of which 7 were critical (p = 0.0017 vs. initial 22 errors). Discussion: This paves the way for future studies testing putative benefits of telemedicine regarding inhaled drug delivery, treatment adherence, disease control, quality of life, and health care burden and costs. Conclusions: A telemedicine intervention aimed at improving the administration of inhaled medication by adult patients at home is feasible, highly appreciated by patients, and effective at correcting medicine administration errors.

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