DEDICATION

Every challenging work needs self efforts as well as guidance of

elders especially those who was every close to my heart.
My humble effort I dedicate to my sweet and love

FATHER AND MOTHER

Whose affection, love encouragement and prays of day and night
make me able to get such success.

Along with all hard working and respected

TEACHERS

ACKNOWLEDGEMENTS

I owe great many thanks to great many people who support me

during the writing of this project.
I am deepest thanks Dr. Altayeb Mhammed altayeb the Guide
of the project for guiding and correcting various document of
mine with attention and care .He has taken pain to go through the
project and make necessary correction as and when needed.
I am expressing my thanks to the principal of Omdurman
Islamic university _faculty of pharmacy, for extending his
support.
I am would also thank my faculty members without whom this
project would have been distant reality. Also extend my heartfelt
to my family and well wishers.

Table of contents

Serial

Contents

No

Page
No

Title page

Dedication

II

Acknowledgement

III

Table of contents

IV

List of tables

List of figures

VI

Abbreviations

VII

Abstract

VIII

10

Chapter 1

11

Introduction

Literature review

12

Chapter 2

Methodology

13

Chapter 3

Results

14

Chapter 4

Discussion

30

15

Chapter 5

Conclusion & Recommendations

33

References

34

16
Appendix I

Questionnaire

LIST OF TABLE
Table

Title of tables

s. No

Page.
No

3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8

Distribution
Distribution
Distribution
Distribution
Distribution
Distribution
Distribution
Distribution

of the participants according to

of the participants according to
of the participants according to
of the participants according to
of the participants according to
of the participants according to
of the participants according to
of the participants according

3.9

home
Distribution of the participants according to satisfy with the relief after the

17

3.10

inhaler administration
Distribution of the participants according to priming and press the MDI into the

18

3.11
3.12

Air
Distribution of the participants according to inhalation technique of MDI
Distribution of the participants according to all steps of inhalation technique

19
20

3.13

of MDI (n=60)
Distribution of the participants according to steps of cleaning metered dose

21

3.14
3.15
3.16

inhaler
Distribution of the participants according to duration time of cleaning MDI
Distribution of the participants according to the quantity of actuation in MDI
Distribution of the participants according to a count of remain dose in MDI

22
23
24

3.17

after use
Distribution of the participants according to the method of remain dose in MDI

25

3.18

Chi-square test for association of perform peak flow reading at home and

26

3.19

learning of MDI technique

Chi-square test for association of press MDI into air if new or not used for

27

3.20

several weeks and learning of MDI technique

Chi-square test for association of the all the steps of metered dose inhaler use

28

3.21

and learning of MDI technique

Chi-square test for association of the cleaning metered dose inhaler and

28

3.22

learning of MDI technique

Chi-square test for association of know the quantity of actuation in MDI and

29

3.23

level of education
Chi-square test for association of count the remain dose in MDI after use and

29

level of education

age
sex
education
Smoking
healthy Insurance
source of learning on use of MDI
duration time on use of MDI
to perform peak flow reading at

9
10
11
12
13
14
15
16

LIST OF FIGURE
Fig.

Title of figure

No

Page.
No

3.1

Distribution of the participants according to age

3.2

Distribution of the participants according to sex

10

3.3

Distribution of the participants according to education

11

3.4

Distribution of the participants according to Smoking

12

3.5

Distribution of the participants according to healthy Insurance

13

3.6

Distribution of the participants according to source of learning on use of MDI

14

3.7

Distribution of the participants according to duration time on use of MDI

15

3.8

Distribution of the participants according to perform peak flow reading at home

16

3.9

Distribution of the participants according to satisfy with the relief after the

17

3.10

inhaler administration
Distribution of the participants according to priming and press the MDI into the

18

3.11

Air
Distribution of the participants according to inhalation technique of MDI

19

3.12

Distribution of the participants according to all steps of inhalation technique of

20

3.13

MDI (n=60)
Distribution of the participants according to steps of cleaning metered dose

21

3.14

inhaler
Distribution of the participants according to duration time of cleaning MDI

22

3.15

Distribution of the participants according to the quantity of actuation in MDI

23

3.16

Distribution of the participants according to a count of remain dose in MDI after

24

3.17

use
Distribution of the participants according to the method of remain dose in MDI

25

ABBREVIATIONS

ABET

Adult Basic Education and Training

PMDI

pressured Metered Dose Inhaler

CFC

Chlorofluorocarbons

COPD

Chronic Obstructive Pulmonary Disease

DPI

Dry Powder Inhaler

ER

Emergency Department

HFA

Hydro-fluoroalkanes

LABA

Long Acting Beta 2 Agonist

MDI

Metered Dose Inhaler

NAEPP

National Asthma Education and Prevention

Programmes of America
NICE

National Institute for Health and Clinical

Excellence
PIL
REPC
SPSS
2
WHO

Patient Information Leaflet

Research Ethics and Publications Committee
Statistical Package of Social Sciences
Chi-squared
World Health Organization

ABSTRACT
BACKGROUND
Inhaled medications are the cornerstone of asthma therapy. Metered dose
inhaler technique is a widely used technique to administer medications like
corticosteroids. In asthma self-management, ineffective inhalation technique
and mishandling of devices is a common and widespread issue even among
experienced adults. Patients need to understand knowledge and awareness
on the use of MDIs.

AIM
The aim of the study was to assess employed patients understanding of all
steps of MDI technique correctly and to evaluate their education in cleaning
of MDI properly seen in Khartoum chest hospital.

METHODOLOGY
A descriptive cross-sectional study was undertaken with sixty randomly
selected participants from October to November 2014 attending to
emergency department of Khartoum chest hospital. Evaluation tool was
adapted from the National Asthma Education and Prevention Programmes of
America (NAEPP) step criteria for the Administration of a metered dose
inhaler. A structured questionnaire was used for data collection and data
analysis was done using Microsoft Excel spreadsheet and SPSS software.

RESULTS
8

Sixty percent (60 %, n= 36) of the participants were females and forty
percent (40 %, n=24) were males. Most of participants did not use MDIs
correctly (92 %, n= 55) where as only (8 %, n= 5) was shown to use MDIs
correctly. Twenty seven percent (27 %, n= 16) only cleaned MDIs prior their
use while (73 %, n= 44) did not. The majority of the participants were unable
to correctly demonstrate all the steps in the practical use of the MDI and not
aware to clean.

CONCLUSION
The majority of the participants lacked knowledge and skill of effective use of
the MDIs which shows that most of the participants need instruction to
ensure the rational use of MDIs.

)(
.

,
.

MDI MDI
.

2014 .
) ( NAEPP
.
Microsoft Excel . SPSS

) 60 = ( 36 ) 40 =
(24 .
) 92 = (55 ) 8 = (5
10

 .
) 27 = (16 ) 73 = (44

MDI .

11