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Role of Spoken Language in Assessment of Inhaler Technique: Differences Among English and Non-English Speaking Patients FREE TO VIEW

Stephanie Hon, MD; Nadine Al-Namaani, MD; Rosemary Tsacoyianis, RN; Corey Balbuena, MA; Sucharita Kher, MD
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Tufts Medical Center, Boston, MA

Chest. 2015;148(4_MeetingAbstracts):356A. doi:10.1378/chest.2262408
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SESSION TITLE: Race and Ethnicity in Lung Disease

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 26, 2015 at 04:30 PM - 05:30 PM

PURPOSE: To determine differences in inhaler use among English-speaking patients (ESP) and non-English-speaking patients (NSP).

METHODS: Outpatients at a pulmonary clinic in a tertiary urban academic hospital were asked to complete an anonymous voluntary IRB-approved survey on inhaler technique. These surveys were implemented in written English and Chinese. Data was analyzed using MS Excel and statistics performed in R version 3.1.1. Fisher’s exact test was used except as noted in the results section.

RESULTS: We performed interim analysis of 103 surveys (16 NSP, 87 ESP). Chinese-speaking patients are the second largest population (after ESP) at our hospital and comprise 100% of the NSP in this study. Baseline characteristics of the patients were as follows: median age (years) NSP 72(68-78) and ESP 60.5(49-71), p 0.004 (Wilcoxon Rank Sum test); male NSP 13(81%) and ESP 37(44%), p 0.01; median length of use (weeks) NSP 104 (52-364) and ESP 260 (104-520), p 0.055 (Wilcoxon Rank Sum test). NSP were more likely to not know the name of their inhaler compared to ESP: 9(56%) vs. 2(2%); p <0.001. NSP were more likely to be less confident of their inhaler technique compared to ESP: 10(71 %) vs. 22(25%); p 0.001. There was no difference between the two groups in using internet resources to learn inhaler technique: NSP 0(0%) vs. ESP 8(9%); p 0.59. Both groups were not likely to want to attend an additional learning session for using inhalers correctly: NSP 12(92.3%) vs. ESP 64(74.4%), p 0.29. Both groups preferred in-person demonstration of inhaler technique as a means to improve their learning: NSP 6(75%) and ESP 52(64%), p 0.71.

CONCLUSIONS: Interim results suggest that NSP using inhalers are more likely to be older males than ESP. NSP are less likely to know their inhaler name and are less confident of their technique. All patients prefer in-person inhaler demonstrations as a means to improve their technique, but are reluctant to come for a dedicated learning session separate from clinic visits. Thus, the ideal targeted intervention for NSP would be in-clinic teaching by a physician, nurse, pharmacist or mid-level provider. These results are, however, limited by small sample size of NSP.

CLINICAL IMPLICATIONS: This study serves as a stepping stone to designing more effective inhaler education for patients of all ethnic and linguistic backgrounds in order to enhance disease control. Focused inhaler learning should be targeted towards non-English speaking populations to improve their knowledge and technique.

DISCLOSURE: The following authors have nothing to disclose: Stephanie Hon, Nadine Al-Namaani, Rosemary Tsacoyianis, Corey Balbuena, Sucharita Kher

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