Improving Inhaler Technique through Face-to-Face and Multimedia Training: A QI Project in an Ethiopian Chest Clinic.

Background: Although multiple studies have documented the prevalence of poor inhaler techniques in Ethiopia, no quality improvement initiatives have been conducted to provide guidance for improving inhaler techniques and symptom control. This quality improvement project aims to assess the effect of face-to-face demonstrations and multimedia-assisted demonstrations on improving inhaler techniques and symptom control among asthmatic patients attending the Chest Referral Clinic of Tikur Anbessa Specialized Hospital. Method: A total of 50 asthmatic participants using inhalers were recruited. Baseline asthma symptom control was assessed using the Asthma Control Test tool. Thirty of the recruited participants received face-to-face demonstrations from trained healthcare professionals while easy-to-use pictogram pamphlets and adapted videos were distributed. Inhaler techniques and asthma control were reassessed using adapted checklists and the Asthma Control Test, respectively, four weeks after the demonstrations and trainings were delivered. Finally, pre-intervention and post-intervention outcomes were analyzed and compared to quantify the impact of the implemented trainings. Results: A total of 30 participants underwent both pre- and post-intervention assessments of inhaler techniques and Asthma Control Test scores. There was a marked improvement in the proper use of inhalers, increasing from 10.5% to 52.6% among participants using dry powder inhalers (P = 0.007) and from 7.1% to 35.7% (P = 0.011) among those using metered dose inhalers. Conclusion: Face-to-face demonstrations of inhaler techniques, when supported with multimedia resources, significantly improved proper inhaler use among asthmatic patients. This project demonstrated a general trend toward better symptom control as measured by the Asthma Control Test post-intervention.