Addressing inhaler technique challenges in cognitively impaired chronic obstructive pulmonary disease patients: the impact of customized training programs
Bibliographic record
Abstract
Individuals with chronic obstructive pulmonary disease (COPD) and cognitive impairment (CI) often face difficulties accurately administering inhalers, which are essential for managing their respiratory condition. Many elderly individuals make major errors that prevent proper medication administration. Maintaining proper inhaler use skills is critical in controlling COPD. Our goal was to examine and evaluate the inhaler use skills of CI patients with COPD during both the initial evaluation and subsequent appointments. The Respiratory Department of KLEs Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, Karnataka, India, was the site of this prospective interventional study. Based on the Montreal Cognitive Assessment Scale (MoCA), a subset of patients with COPD exhibited mild CI. Patients exhibiting improper inhaler-using skills were detected, corrected, and trained. Inhaler techniques were reassessed immediately and at follow-up visits. The modified Medical Research Council scale score (mMRC), COPD Assessment Test (CAT) score, St. George Respiratory Questionnaire (SGRQ), and pulmonary function tests were reassessed. A total of 56 COPD and CI patients who had made at least one significant mistake when using an inhaler device were added to the study. The mean age was 66.89±9.85 years. When evaluated with MoCA, the mean score was 17.02±3.91. At baseline, the mean number of mistakes was 1.38±0.93, which decreased to 0.54±0.57 after face-to-face demonstration of correct inhaler techniques. Correlational analysis revealed MoCA scores were negatively associated with the number of mistakes (r=-0.344). At follow-up, the CAT score (25±5.61 vs. 18.48±5.24 p=0.001), SGRQ score (53.82±20.59 vs. 37.61±22.17 p=0.001), mMRC score (3.21±0.76 vs. 3.20±0.75 p=0.001), and forced expiratory volume in 1 second/forced vital capacity score (66.86±9.35 vs. 70.08±9.07 p=0.001) had significantly improved in patients demonstrating the correct technique. Pharmacist-led interventions demonstrated improvements in health-associated quality of life and therapeutic outcomes for individuals with COPD and CI. The study highlighted the importance of cognitive evaluation in routine COPD therapy, identifying potential impediments to effective therapy, and offering face-to-face presentations of inhaler techniques. The best inhalers and methods for COPD patients experiencing CI should be further investigated, according to the study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".