Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Airway diseases

Abstract

Introduction
There are a considerable variety of inhaler devices available. It is important that these are prescribed correctly when a patient is admitted to hospital as incorrect prescribing may have an adverse effect on patient recovery and length of stay. We have investigated the accuracy of inhaler prescribing on the respiratory wards in our hospital.
Methods
All admissions into the respiratory wards (total no of beds =57) between March to May 2010 were included (total 83). All case notes were retrieved and only patients on inhalers or nebulizers were included.
Results
83 patients were admitted of whom 44 (53% of total, age range 20-92, 68% female) were on inhalers or nebulizers prior to admission. COPD (57%) was the main reason patients were on inhalers/nebulizers.

Indications for inhaler/ nebuliser prescribing

COPD	24 (54.5%)
Asthma	7 (15.9%)
Asthma/ COPD	1 (2.3%)
Cystic fibrosis	5 (11.4%)
Bronchiectasis	3 (6.8%)
Asthma/ Bronchiectasis	4 (9.1%)

Detailed accuracy of prescribing on admission during this period is detailed in Table 2.

Inhalers/ nebulisers prescribed on drug chart

	SABA inh	SABA nebs	Steroid inh	LAMA inh	SAMA inh	SAMA nebs	Combined LABA/Steroid
Home use	30 (68.1%)	14 (31.8%)	6 (13.6%)	17 (38.6%)	1 (2.3%)	2 (4.5%)	27(61%)
Prescribed in hospital	16 (53.3%)	25 (179%)	4 (66.7%)	11 (64.7%)	0 (0%)	16 (800%)	25(92.6%)[4 new prescriptions]
Correct dose prescribed	4 (13.3%)	12 (85.7%)	3 (50%)	10 (58.8%)	0 (0%)	2 (100%)	17(63.0%)
Correct device prescribed	2 (6.7%)	NA	0 (0%)	2 (11.8%)	0 (0%)	NA	5(18.5%)

Conclusion
Our results show that inhaler prescribing in hospitalized patients is poor and hospital doctors need to prescribe the correct medication for the patient as a duty of care during their in-patient stay.

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Citations should be made in the following way:
H. Lockman, R. Shrimanker, N. Withers, B. Patel (Exeter, United Kingdom). Accuracy of inhaler and nebulizer prescribing in hospitalized patients. Eur Respir J 2011; 38: Suppl. 55, 486

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