Although community pharmacists have become more involved in the care of
asthma patients, several studies have assessed pharmacists’'ability to
illustrate appropriately inhalation technique of different asthma devices.
Many studies addressed inappropriate use of asthma devices by patients and
pharmacists, in addition to its clinical, humanistic and economic
To evaluate community pharmacists' practical knowledge and skills of
demonstrating proper inhalation technique of asthma inhaler devices
available in Sudan.
Three hundred community pharmacies located around the three major hospitals
in the capital city (Khartoum) and four other provinces were approached, and
four asthma devices were assessed: Metered-dose inhaler (MDI) (n=105), MDI
with Spacer (n=83), Turbuhaler (n=61), and Diskus (n=51). Investigator (a
pharmacist) acted as a mystery patient. He selected one device and asked the
serving pharmacist to demonstrate how to use the device. Investigator
completed a checklist of 9 steps of inhaler device use immediately after
leaving the pharmacy. Essential steps derived from published literature were
pre-specified for each device. Five evaluation categories were accordingly
formulated as follows: optimal technique, adequate technique, poor
technique, totally unfamiliar with the device, and does not know.
More than half of the pharmacists approached with metered dose inhaler did
not know how to use optimal technique (ie all steps correct) all through. A
third poorly demonstrated the technique, and only one pharmacist was
categorized as being able to demonstrate an "optimal technique".
The majority of pharmacists approached with spacing chamber and dry powder
inhalers (Turbuhaler and Diskus) either did not know proper technique or
were totally unfamiliar with the devices.
The majority of community pharmacists, who were expected to educate asthma
patients on their dispensed inhalers, lack the basic knowledge of proper use
of commonly dispensed asthma inhaler devices.