ArticleBMC pulmonary medicine2023
Cognitive impairment according to Montreal Cognitive Assessment independently predicts the ability of chronic obstructive pulmonary disease patients to maintain proper inhaler technique.
Article in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Prevalence and risk of cognitive impairment among patients with asthma: A systematic review and meta-analysis.Brain and behavior · 2025Pooled it
- Trial
- User-Friendliness Evaluation of Handling pMDI with Various Add-on Devices in Asthmatic Patients.AAPS PharmSciTech · 2024Trial
- Inhaler mastery and retention after stepwise training in cognitively impaired older COPD.ERJ open research · 2026Article
- Recognition and Management of Cognitive Impairment in Chronic Obstructive Pulmonary Disease (COPD): Implications of Clinical Confidence.Medicina (Kaunas, Lithuania) · 2026Review
- Inhaled Targeted Nano-Drug Delivery Systems for COPD: Precision Solutions to Clinical Barriers.International journal of nanomedicine · 2026Review
- Using machine learning models to predict the risk of mild cognitive impairment for COPD patients: A multi-cohort study.Comprehensive psychoneuroendocrinology · 2025Article
- Expectations Versus Reality in Inhalation Technique-A Case-Control Study of Inhalation Technique in Patients with Asthma or COPD.Journal of clinical medicine · 2025Article
- Severity Matters: How COVID-19 Severity Impacts Long-Term Effects on Symptoms, Physical Activity and Functionality-An Observational Study.Healthcare (Basel, Switzerland) · 2025Article
- Construction of a prediction and visualization system for cognitive impairment in elderly COPD patients based on self-assigning feature weights and residual evolution model.Frontiers in artificial intelligence · 2025Article
- Recalibrating Perceptions and Attitudes Toward Nebulizers versus Inhalers for Maintenance Therapy in COPD: Past as Prologue.International journal of chronic obstructive pulmonary disease · 2024Review
- Breaking down barriers to COPD management in primary care: applying the updated 2023 Canadian Thoracic Society guideline for pharmacotherapy.Frontiers in medicine · 2024Review
- The use of the MoCA in cognitive impairment for older patients with Chronic Obstructive Pulmonary disease: A preliminary study.Science progressArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMaintaining correct inhaler technique is crucial in the management of chronic obstructive pulmonary disease (COPD). We aimed to investigate the inhaler technique in patients with COPD, to compare it immediately after and at 1 month after training, and to identify the predictors of incorrect inhaler use at 1 month after training.
methodsThis prospective study was conducted at the COPD clinic of Siriraj Hospital (Bangkok, Thailand). Patients demonstrating improper inhaler use were trained face-to-face by pharmacists. Inhaler technique was re-assessed immediately after and at 1 month after training. The Montreal Cognitive Assessment (MoCA) score, pulmonary function tests, 6-min walk distance (6 MWD), modified Medical Research Council scale score, and COPD Assessment Test (CAT) score were evaluated.
resultsSixty-six patients with COPD who demonstrated at least one critical error during the use of any controller inhaler were enrolled. The mean age was 73.0 ± 9.0 years, and 75.8% patients had moderate/severe COPD. Immediately after training, all patients used dry powder inhalers correctly and 88.1% used pressurized metered-dose inhalers correctly. At 1 month, the number of patients demonstrating the correct technique decreased across all devices. Multivariable analysis revealed that MoCA score ≤ 16 was independently associated with a critical error at 1 month after training (adjusted odds ratio: 12.7, 95% confidence interval: 1.8-88.2, p = 0.010). At 1 month, CAT score (11.4 ± 8.9 vs. 8.4 ± 5.5, p = 0.018) and 6 MWD (351 ± 93 m vs. 372 ± 92 m, p = 0.009) had significantly improved in patients demonstrating the correct technique, and CAT score met the minimal clinically important difference.
conclusionsFace-to-face training by pharmacists improved patient performance. However, the number of patients following proper technique had decreased at 1 month after training. Cognitive impairment (MoCA score ≤ 16) independently predicted the ability of COPD patients to maintain proper inhaler technique. Assessment of cognitive function combined with technical re-assessment and repeated training should improve COPD management.
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