Perceptions of inhalers and associated factors among patients with bronchial asthma attending the Respiratory Clinic at Teaching Hospital Jaffna

Abstract

Background and objective: Effective asthma management requires educating patients about the disease, triggers, and proper management protocols. Inadequate patient education, negative attitudes towards medication and poor adherence to inhaler therapy are common issues in asthma management. These factors can lead to uncontrolled asthma, highlighting the importance of routine assessment of inhaler practice and patient education to enhance treatment outcomes. The objective of this study was to determine the knowledge, attitude, practice and beliefs regarding inhalers and associated factors among patients with bronchial asthma attending the Respiratory Clinic at Teaching Hospital Jaffna. Methods: This mixed method study was conducted among 150 patients with bronchial asthma on inhalers and under follow up for at least one month at the Respiratory Clinic, Teaching Hospital Jaffna. An interviewer-administered questionnaire was used to collect quantitative data from all patients who fit the study criteria, while two focus group discussions with patients recruited by purposive sampling were held as part of the qualitative component. Data was analyzed using IBM SPSS Statistics 20 and thematic analysis for the quantitative and qualitative components, respectively. Results: The majority were prescribed pressurized metered dose inhalers (92%). In the sample, 88% of participants did not skip taking their inhalers. A significant association was found between educational level and preference for inhaler medication over oral medication (p=0.006). The study revealed that 27.3% used an inhaler with a spacer, and 83.3% were prescribed a different type of inhaler during exacerbations. No significant associations were found with socio-demographic factors, except for religion in certain cases. Both positive and negative aspects of inhalers were noted in the focus group discussions. Only a minority of the participants had misbeliefs. Conclusion and recommendations: Overall, the study highlights the diverse duration of inhaler prescriptions and preferences among bronchial asthma patients. For better inhaler utilization, misconceptions should be addressed and clear explanations should be provided along with assessment of inhaler technique.