© 1997 Oxford University Press
research-article |
Competence thresholds for the use of inhalers in people with dementia
Department of Medicine, The Royal Bournemouth Hospital Castle Lane East, Bournemouth, Dorset, UK
METHODS:: the ability to learn three inhaler techniques of increasing levels of complexity was studied in 50 normal and demented inhaler-naive elderly people (mean age 81 years) with stable 10-point mini-mental test scores (MTS). There were 10 subjects in each of the following groups: MTS 8–10 (non-demented), MTS 7 (borderline), MTS 6 (mild dementia), MTS 5 and MTS 4 (2 moderate dementia groups). The techniques were taught on one day and reassessed on the following day on consecutive days in ascending order of complexity.
RESULTS:: those with an MTS of 4 were unable to learn any of the techniques, while all the non-demented people could learn all three techniques. For the five-stage technique (standard metered dose inhaler) the 0% threshold (i.e. when none of the subjects was able to learn) was MTS 6, the 50% threshold (at least half but not all could learn) MTS 7 and the 100% threshold (all could learn) MTS 8. For the four-stage technique (inhaler with large spacer) the 0% threshold was MTS 5, the 50% threshold MTS 6 and the 100% threshold MTS 8. For the three-stage technique (inspiration-triggered inhaler) the 0% threshold was MTS 4, the 50% threshold MTS 5 and the 100% threshold MTS 7.
CONCLUSIONS:: MTS can be used to determine the likelihood of a mild or moderately demented patient being able to learn a multiple-stage inhaler technique.
Keywords: asthma, competence threshold, dementia, inhaler use
Received May 30, 1996;
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. C. Allen and M. Baxter A comparison of four tests of cognition as predictors of inability to perform spirometry in old age Age Ageing, September 1, 2009; 38(5): 537 - 541. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Allen and P. Yeung Inability to draw intersecting pentagons as a predictor of unsatisfactory spirometry technique in elderly hospital inpatients. Age Ageing, May 1, 2006; 35(3): 304 - 306. [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Roland, R. K. Bhalla, and J. Earis The Local Side Effects of Inhaled Corticosteroids: Current Understanding and Review of the Literature Chest, July 1, 2004; 126(1): 213 - 219. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S C Allen and S Ragab Ability to learn inhaler technique in relation to cognitive scores and tests of praxis in old age Postgrad. Med. J., January 1, 2002; 78(915): 37 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Wagner, G van der Wal, P P Groenewegen, and D H de Bakker The effectiveness of quality systems in nursing homes: a review Qual. Saf. Health Care, December 1, 2001; 10(4): 211 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Diggory, C. Fernandez, A. Humphrey, V. Jones, and M. Murphy Comparison of elderly people's technique in using two dry powder inhalers to deliver zanamivir: randomised controlled trial BMJ, March 10, 2001; 322(7286): 577 - 577. [Abstract] [Full Text]
|
|
|
|
 |
|
 Inhaler devices for asthma DTB, February 1, 2000; 38(2): 9 - 14. [Abstract] [Full Text] [PDF]
|
|