Effect of Educational and Policy Interventions on Institutional Utilization of Wet Nebulization Respiratory Drugs and Portable Inhalers

Authors: 
Donna O. Lowe, Heather Lummis, Ying Zhang, Ingrid S. Sketris
Research Summary: 

Purpose of Study
The purpose of this study was to examine the effect of educational and policy interventions on the use of salbutamol, ipratropium bromide, and spacer devices.

Research Approach/Method
The authors performed a time-series analysis of data from monthly drug and spacer device use at a 1000-bed teaching hospital. They staged two intervention phases.

Key Overarching Message
Results suggest hospital- and community-based education and community-based provincial drug policy change had limited effects on converting wet nebulization respiratory drug therapy to portable inhaler use in this institution. Further work is required both to explore reasons and to implement other approaches.

Key Findings
The multifaceted interventions were associated with increased usage rates of salbutamol and ipratropium bromide portable inhalers in both intervention phases I and II, as compared to the pre-intervention phase (p < 0.05). Increased portable inhaler use, however, corresponded to very modest and nonsignificant decreases in usage rates of salbutamol and ipratropium bromide wet nebulization in both intervention phases I and II, as compared to the pre-intervention phase. Monthly spacer device utilization rates increased significantly in both intervention phases I and II, as compared to the pre-intervention phase (p < 0.001 for both).