A Clinical Benefit of Training Asthmatic Patients on How to Use Metered Dose Inhalers by using the 2Tone Trainer In Libya

Bronchial asthma is a serious chronic inflammatory disease of the respiratory system. Aerosol inhalation as a route of drug delivery has become well-known in therapy of asthma. This study was designed to evaluate if the use of 2Tone helps patients maintain the correct inhalation technique after training and can improve the clinical benefit. 125 Libyan adult asthmatic patients were recruited. At the first clinical visit; 38, 44 and 43 patients were included as C, VT and 2T groups, respectively. Their inhalation flow rate through an MDI was measured using an In-Check Dial. Patients in 2T group were trained on how to use the 2Tone Trainer according to its PIL and practiced inhaling through this training aid to familiarize themselves with the different sounds according to the inhalation rates. At the second clinic visit for all the patients was held six weeks later, each patient was assessed in the same manner as on the first visit. Results show no significant difference in the change of FEV1 and PEFR between all the groups. Lung function measurements, percent predicted FEV1 and PEFR showed significant low correlation with all AQLQ domains, except for AQLQ environment which found no correlation with lung function measurement. Significant correlations between percent predicted FEV1 and PEFR with all AQLQ domains. Patients in the 2T group showed reduced IFR of about double that in VT group, whereas in the C group, there was no difference in IFR. Comparison of IFR between VT vs. 2T groups at visit one showed no statistical significant difference. However, at visit two, comparison between all the groups showed a highly significant difference. Thus, this study shows that 100% and 29% of the patients in the C and VT groups were inhaling at a high IFR while the 2T group shows only one patient (3%) was inhaling at the high flow rate while the rest of the patients managed to obtain the optimum IFR needed for the MDIs. Thus, the present findings show the importance of the use of the 2T device to train the patients to slow their IFR.