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Asthma is a chronic airway inflammation characterized by recurrent attacks, airway hyperresponsiveness, mucus hypersecretion, and airway obstruction. It ranks 16th among the most serious diseases in terms of duration and severity of disability. The disease poses a significant social and economic burden and morbidity for families and the healthcare system. It is estimated that approximately 300 million people worldwide are affected by asthma, and this number is expected to reach 400 million by 2025. Symptoms, airflow limitation, and its degree vary significantly over time in asthma. These changes are generally influenced by various stimuli, such as the presence of allergies or irritants, physical activity, air changes, or respiratory infections. Therefore, proper management of asthma, which poses a significant problem for both patients and society, is crucial. The goals of asthma treatment are to provide symptom control, reduce exacerbations, and alleviate fixed airway obstruction and medication side effects. Oral, parenteral, and inhaled agents are currently used in treatment. Inhaled treatments offer advantages over other treatment methods because they deliver medications directly to the airways and accumulate there, resulting in a faster onset of action and fewer side effects due to the use of smaller doses. Because inhaled medication must reach the targeted airways for it to be effective, proper inhalation technique is as important as adherence to treatment. However, it is known that 70-80% of patients fail to use their inhalers correctly. Failure to use inhalers properly and correctly leads to ineffective treatment, uncontrolled disease, frequent attacks, increased medication use, hospitalizations, and increased costs. Therefore, the most fundamental element of asthma treatment is inhaler use training. In addition to providing information about the disease, the patient should be thoroughly and practically instructed on how and when to use asthma medications. However, studies conducted in our country have shown that the rate of inhaler use using the correct technique is quite low. However, asthma management education has been proven effective in improving asthma control and quality of life. Numerous studies confirm that the use of smartphone-based apps is a promising educational tool. Effective use of new mobile apps and smart technologies is also noted to be important in improving treatment adherence rates, improving inhaler technique, and improving asthma control. Therefore, this study aimed to evaluate the effects of video-animated inhaler medication education on medication adherence, seizure frequency, and dyspnea in asthmatic patients.
Full description
Asthma is a disease characterized by recurrent airway obstruction that can impair patients' quality of life and mental well-being. Asthma, which has a high prevalence among chronic diseases, is a significant public health problem among respiratory diseases. It can occasionally cause increases in symptom frequency and severity and can be life-threatening. Disease control in asthma is defined as the degree to which various symptoms of asthma are reduced or eliminated with treatment. Uncontrolled asthma imposes a significant social and economic burden on asthma patients. The cornerstones of treatment are guideline-based medication regimens and asthma education programs aimed at equipping patients for effective self-management. Poor disease control in asthma can result from patients being prescribed inappropriate medications or using prescribed medications incorrectly. Airway obstruction, associated with narrowing of the airway lumen, the most characteristic feature of asthma, is reversible with bronchodilator therapy . For inhalation therapy, the patient's choice of device that is easy and accurate to use and the correct inhaler technique are crucial. Device selection not only increases the success of medication administration but also improves patient compliance and asthma control. Improper inhaler technique can lead to patients receiving inadequate medication doses. This not only limits medication effectiveness but can also lead to side effects. Furthermore, even if the patient uses the medication as prescribed, incorrect inhaler technique can lead to poor disease control. Education is crucial in preventing or managing these problems. Nurse educators, as part of their role as educators, can identify the patient's learning potential and, through training, ensure that the patient uses inhaled medications correctly, thus increasing treatment success. Studies have shown that inhaler device training has significant positive effects on the correct use of the device. Gregoriano C. et al. concluded in their study that correct medication inhalation has a positive impact on health status and lung function. A study by Al-Kharouf MS and colleagues concluded that video-based training is effective in improving inhaler technique over time, as well as improving disease control, medication adherence, and quality of life. However, it is known that 70-80% of patients fail to use their inhalers correctly. One study found that the incidence of nonadherence was 47.6% based on patient reports and 48.5% based on pharmacy records. Paske et al. concluded that approximately 70% of asthma patients use inhaled medications incorrectly, leading to decreased disease control, increased healthcare utilization, and increased costs. A study by Mortan et al. found that patients generally have poor inhaler technique, resulting in suboptimal asthma control. A meta-analysis found that the reduction in the likelihood of exacerbations was greatest in patients with 80% or greater adherence to treatment, but a reduction was also observed among those with greater than 50% adherence. These results suggest that greater emphasis should be placed on the educational component of treatment. The standard mode of inhaler technique training in many studies has been written materials or verbal instructions. Single-session verbal training has a temporary effect on improving inhaler technique. One-on-one training sessions that include physical demonstrations of inhaler use are significantly more effective than written training. However, several studies have clearly demonstrated that inhaler technique deteriorates if training is not repeated within 1 to 3 months of physical demonstration. It is emphasized that at least three training sessions are necessary to develop effective inhalation technique. Although technique improves after verbal training, this can lead to inadequacies over time and requires reinforcement with different educational strategies. Video training tools have been used since the early 2000s and are considered useful interventions for promoting medication adherence and behavioral changes in patients. These tools can account for different learning preferences by providing patients with visual and auditory information about their medications and can be used to reinforce the importance of medication adherence and high-risk medications.Video education tools can also be used to address common patient concerns and can be adapted to meet individual patient needs, including language and literacy levels. Therefore, the development of patient education videos is thought to be beneficial in improving patient outcomes. Based on these results, we planned to evaluate the effects of video animation-assisted inhaler medication education on medication adherence, seizure frequency, and dyspnea in asthmatic patients.
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42 participants in 2 patient groups
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