الفهرس 
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Abstract
Introduction:
Patients’ incorrect use of their metered dose inhalers (MDIs) and dry powder inhalers (DPIs) is a major reason for poor asthma and chronic obstructive pulmonary disease (COPD) control.
Hence, the aim of the present work was to study the role of MDI & DPI counselling on patients inhalation technique and their lung function test scores.
Methods:
For DPI: 310 (164 female) asthma or COPD subjects using aerolizer DPI were collected from Beni Suef University hospital outpatient clinics through a two year study period with mean (SD, range) age 48.7 (13.1, 19-77) years old. Their results were collected as whole one group and divided into 3 different age groups. For MDI: 491 (281 female) asthma or COPD patients were collected from Beni Suef University hospital outpatient clinics through a two year study period with mean (SD, range) age 42.1 (17.1, 10-78) years old. Their results were collected as whole one group and divided into 4 different age groups. Their DPI & MDI inhalation techniques were checked and the number of mistakes was detected and corrected at the start of the study and every month for two months (three visits). Their peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) as percentage of the forced vital capacity (FVC) were checked at every visit.
Results:
For DPI, The mean number of mistakes observed was significantly decreased (p<0.001) as the number of visits increased. “To inhale fast” and “To maintain a fast inhalation rate until the lungs are full” were the most common repeated mistakes. There was a significant increase (p<0.001) in the pulmonary function test after the period of counselling in all age group.
For MDI, The mean number of mistakes observed was significantly decreased (p<0.001) as the number of visits increased especially in children age group. “To maintain a slow inhalation rate until the lungs are full” was the most common repeated mistake. There was a significant increase (p<0.001) in the pulmonary function test after the period of counselling in all age group particularly in >60 years old patients.
On comparison between MDI & DPI; There was no significant difference between them in the pulmonary function test results in all visits except the FEV1/FVC% of the age group (40-60) years in the 2nd visit (p=0.037); the MDI FEV1/FVC% results were significantly higher than DPI. The MDI total number of mistakes results was significantly higher than DPI results for all groups in all visits.
Conclusions:
DPI’s & MDI’s counselling should be repeated at every opportunity to improve and maintain the recommended inhalation technique and possibly improve patients’ lung function test scores. aerolizer DPI is much easier to learn and remember its inhalation technique compared to MDI.