Muhammad Hammad Athar, Usama Bin Zubair, Barik Hassan Ahmed.
Impact of proper metered dose inhaler technique over peak expiratory flow rate in moderate persistent bronchial asthma.
Pak Armed Forces Med J Jan ;68(4):975-79.

Objective: To determine the impact of proper metered dose inhaler technique over peak expiratory flow rate (PEFR) among the patients of moderate persistent bronchial asthma. Study Design: Randomized controlled trial. Place and Duration of Study: Military Hospital Rawalpindi, Six months, from Dec 2017 to Jun 2018. Material and Methods: The sample population comprised of patients suffering from moderate persistent bronchial asthma presenting in medical outpatient department. Patients were divided into two groups. Patients in group A were not educated regarding proper technique for using metered dose inhaler and used the faulty technique. Patients in group B were educated regarding proper technique for using metered dose inhaler. Peak expiratory flow rate was determined via standard peak expiratory flow rate device in both the groups after the inhalation of standard dose of salbutamol. Mean PEFR was calculated and compared for both the groups. Results: The mean peak expiratory flow rate score of patients without the education of proper technique was 320 ± 9.28 whereas mean PEFR score in patients after the proper metered dose inhaler technique was 460 ± 6.66 (p-value<0.001). The PEFR scores after the use of metered dose inhalers with proper technique were significantly higher than those without the use of proper technique. Conclusion: This study showed that proper use of metered dose inhaler device has a significant impact on the peak expiratory flow rate. Proper time should be given by the physician or pharmacist to explain the patient regarding proper use of this device in order to ensure its optimal functioning.

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