Empowering the Patient With Chronic Obstructive Pulmonary Disease: Optimizing Inhalation Technique.

Introduction Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disease characterized by chronic respiratory symptoms. Validated tools such as the modified Medical Research Council (mMRC) and COPD Assessment Test (CAT) questionnaires are commonly used to assess these symptoms. In Portugal, it is estimated that COPD affects approximately 14.2% of individuals aged 40 and over. Compliance with inhalation therapy remains a significant challenge. Inconsistent and incorrect use of inhalers contributes to suboptimal disease control and deteriorates the patients' quality of life. Regular evaluations provide a valuable opportunity to monitor symptom progression, assess therapeutic compliance, and understand patients' beliefs and expectations about their treatment. Objective The primary aim of this study was to enhance the correct use of inhalers at the Porto Centro Family Health Unit by at least 20% of the COPD patients included. The secondary goal was to evaluate how inhaler therapy compliance and proper technique impact the symptomatic control of COPD, as measured by the mMRC and CAT scales. Methods A prospective observational cohort study was developed, with an intervention component. Data were gathered through random sampling of patients diagnosed with COPD. Participants were invited for an initial evaluation, where they were educated about the disease, instructed on the correct inhalation technique, and assessed for both symptom severity and inhaler technique. They were then re-assessed at a follow-up visit. Descriptive and analytical statistical methods were applied to compare and interpret the results. This study was approved by the Ethics Committee of Local Health Unit São João. Results A total of 60 patients were randomly selected for participation. After applying exclusion criteria, refusal to participate, and missed appointments, 19 participants completed the study. Approximately two-thirds of the patients initially failed at least one step of the inhalation technique. Following the intervention, 79% of the patients were able to correctly perform all steps, reflecting a 47% improvement. Symptom assessment using the CAT questionnaire showed scores ranging from 8 to 21 (median = 8) at the first visit, which improved to a range of 0 to 21 (median = 4) at the follow-up visit. In terms of mMRC scores, only one patient showed a worsening of dyspnea classification, three patients improved, and the remaining patients had stable classifications. Discussion Inhalation therapy is crucial for effective COPD management. Following the intervention, a 47% improvement in inhaler technique was observed, which could lead to better disease control, fewer hospital admissions, and an enhanced quality of life. Although there are limitations such as the small sample size, the study demonstrated symptom improvement between the first and second visits, potentially indicating improved disease management. Conclusions This study highlights the impact that a focused intervention in managing COPD can have on improving patient outcomes and quality of life.