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Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta-Analysis

dc.contributor.authorMaricoto, Tiago
dc.contributor.authorMonteiro, Luís
dc.contributor.authorGama, Jorge
dc.contributor.authorSousa, Jaime Correia de
dc.contributor.authorBarata, Luis Taborda
dc.date.accessioned2020-02-10T10:59:25Z
dc.date.available2020-02-10T10:59:25Z
dc.date.issued2019-01
dc.description.abstractOBJECTIVES: To evaluate the effect of inhaler education programs on clinical outcomes and exacerbation rates in older adults with asthma or chronic obstructive pulmonary disease (COPD). DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: Older adults with asthma or COPD, either in primary or secondary health care and pharmacy setting. MEASUREMENTS: We searched the Medline, Embase, and Central databases according to the main eligibility criteria for inclusion: systematic reviews, meta-analysis, clinical trials and quasi-experimental studies; participants aged 65 and older; education on inhaler technique and reporting of disease control and exacerbation rates. We used the Grading of Recommendations, Assessment, Development and Evaluations scale for quality assessment and used a random-effect model with Mantel–Haenszel adjustment to perform a meta-analysis. RESULTS: We included 8 studies (4 randomized, 4 quasiexperimental) with a total of 1,812 participants. The most frequent type of intervention was physical demonstration of inhaler technique, training with placebo devices. Five studies showed significant reduction in exacerbation rates (pooled risk ratio=0.71, 95% confidence interval=0.59–0.86; p < .001), although effect on disease control and quality of life showed high discrepancy in the reported results, and all randomized studies revealed uncertainty in their risk of bias assessment. CONCLUSION: All interventions seemed to improve inhaler performance and clinically relevant outcomes, but a placebo device could be the most effective. There is evidence that interventions reduce exacerbation risk in older adults, although to an overall moderate degree.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1111/jgs.15602pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.6/9162
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectAsthmapt_PT
dc.subjectChronic obstructive pulmonary diseasept_PT
dc.subjectInhalerspt_PT
dc.titleInhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta-Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage66pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage57pt_PT
oaire.citation.titleJournal of the American Geriatrics Societypt_PT
oaire.citation.volume67pt_PT
person.familyNameMaricoto
person.familyNameReis Gama
person.familyNameBotelho Correia de Sousa
person.familyNameTaborda Barata
person.givenNameTiago
person.givenNameJorge Manuel
person.givenNameAntonio Jaime
person.givenNameLuis
person.identifierH-5607-2015
person.identifier104007
person.identifier.ciencia-id1017-111B-5EF4
person.identifier.ciencia-idE81F-1C44-F08D
person.identifier.ciencia-id9414-18D1-7C76
person.identifier.ciencia-id1E1F-8A43-055B
person.identifier.orcid0000-0002-4201-9565
person.identifier.orcid0000-0003-3926-580X
person.identifier.orcid0000-0001-6459-7908
person.identifier.orcid0000-0001-6649-8890
person.identifier.scopus-author-id7102813038
person.identifier.scopus-author-id15128160500
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationed3d132f-296f-4937-bc5e-d3471865306e
relation.isAuthorOfPublication4b605a0e-d32e-4d60-9e39-0290f57c3ff6
relation.isAuthorOfPublication70b5de99-37d8-4841-9596-b263d529e65a
relation.isAuthorOfPublication3f1ad371-56e3-4fda-9409-748e355a0de1
relation.isAuthorOfPublication.latestForDiscovery70b5de99-37d8-4841-9596-b263d529e65a

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