Asthma & Allergic Disorders in Older Adults Committee at American Academy of Allergy, Asthma and Immunology - AAAAI
I’ve been working for the past few years towards trying to change the standards of practice in determining, for patients with various pulmonary disorders, that the procedure to follow prior to prescribing an inhaled medication, that the protocol should be (and the the PBM Tier system): 1) Cognitive evaluation 2) Dexterity check 3) PIFT: does the patient have at least 50 l/min inhaled flow to utilize a DPI? And the test done through a device that adjusts for the various resistance levels of the assortment of units. 4) Shared decision making.. are they comfortable with the choice. This is followed by Teach-back training to be done by staff that has had training to confirm they themselves can execute properly (research reflects an 87% failure rate in healthcare providers. The Teach-back includes the patient explaining the “why” behind every step of execution. Additionally, in follow up visits, they are re-evaluated by staff, prior to seeing the medical provider. Final process: In regards to MDI’s and DPI’s, add on units which not only remind patients to take their meds, but also track use, techniques, and now with a number of these newer devices, monitor and track, using Bluetooth, the Peak Inspiratory Flow Rate. With DPI’s, above 50 l/min. With MDI’s.. rate should be 20 l/min This is monitoring that the practices can follow, and reduce the risk of exacerbations. #healthcaresquad
Asthma & Allergic Disorders in Older Adults Committee at American Academy of Allergy, Asthma and Immunology - AAAAI
8moThank you Samir!