The Effect of İnhaler Training and Reminders on Medication on Adherence in Elderly Individuals

The presence of multiple comorbidities and an increased number of medications in elderly individuals are significant risk factors for non-adherence to inhaler therapy. Forgetfulness, lack of confidence in medications and difficulty understanding how to take them, depression, low self-efficacy, disease severity, and disease perception can all affect adherence to treatment. Incorrect inhaler use can lead to patients receiving insufficient medication, increased symptom burden, and negatively impact their quality of life. Furthermore, incorrect inhaler technique has been shown to increase the risk of hospitalization, emergency room visits, and the use of antibiotics and oral corticosteroids. Implementing procedures to ensure correct inhaler use is crucial in controlling critical errors in inhaler therapy. Elderly patients are more likely to have conditions such as arthritis that affect physical movement and coordination. Cognitive function also affects the ability to use inhaler devices correctly. It is known that incorrect inhaler use is more common, particularly in untrained and elderly individuals, with frequent errors including poor hand-mouth coordination, inability to synchronize spraying and inhalation, and failure to hold the breath during inhalation being common mistakes in metered-dose inhaler use. Therefore, this study will evaluate the effect of metered-dose inhaler training and reminders on treatment adherence in elderly individuals.

Inclusion criteria

for the study:

• Age ≥ 65 years old
• Having at least basic literacy,
• Receiving metered-dose inhaler therapy for at least 6 months,
• Being hospitalized in the pulmonary ward,
• Presenting to the pulmonary function test unit,
• Presenting to the pulmonary outpatient clinic,
• Signing the informed consent form for participation in the study,
• Having internet access and a mobile device with Android/iOS operating system,
• Being able to use a telephone,
• Having no communication barriers,
• Being able to use the inhaler without needing assistance,
• Making an error in at least one of the usage steps according to the MDI usage skills chart.

Exclusion criteria

for the study:

• Age <65
• Illiteracy
• Receiving metered-dose inhaler therapy for <6 months
• Outpatient treatment
• Being hospitalized in the intensive care unit
• Being hospitalized in wards other than the pulmonary ward (such as surgery, physical therapy)
• Visiting outpatient clinics other than the pulmonary clinic (such as surgery, physical therapy)
• Not signing the informed consent form for participation in the study
• Not having internet access and a mobile device with Android/iOS operating system
• Not having telephone skills
• Having communication barriers
• Requiring assistance while using the inhaler
• Not making any errors in the usage steps according to the MDI usage skills chart
• Wanting to withdraw from the study/withdrawing from participation during the research process
• Not completing the questionnaire