Video-Based Education Improves Inhaler Use Among Adults With COPD


A video-based teach-to-goal (TTG) intervention was able to improve inhaler technique over time among patients with chronic obstructive pulmonary disease (COPD) and asthma, according to a randomized controlled trial.

The use of a video-based teach-to-goal (TTG) education intervention showed improved inhaler technique over time among adults with chronic obstructive pulmonary disease (COPD), with potential benefits including improved disease control, medication adherence, and quality of life (QOL). The findings of the prospective, open-label, randomized controlled trial were published in PLoS One.

“This is the first RCT [randomized controlled trial] investigating the effect of a video-based teach-to-goal educational intervention on inhaler technique mastery, in addition to its effect on disease control, disease-related quality of life, and medication adherence among adults with asthma and COPD over a period of 3 months,” the study authors wrote.

Incorrect inhaler use is known to be associated with poor patient outcomes. Although verbal education strategies have been found to improve inhaler technique, the efficacy of this approach is known to decline over time, suggesting a need for alternative solutions, according to the authors.

The researchers aimed to investigate whether video-based TTG education intervention would improve inhaler technique, disease management, medication adherence, and disease-related QOL over time among adults with COPD and asthma.

A total of 926 patients were initially recruited, with eligibility requirements being an established COPD or asthma diagnosis and chronic use of an inhaler for at least 1 month. After exclusion, 152 patients were enrolled in the study.

Patients were randomly assigned to either receive verbal TTG inhaler technique education or a video-based TTG intervention, which consisted of a series of videos outlining the necessary steps for proper inhaler technique, defined using a standardized checklist. These videos were shown to the patients on a smartphone and would display until the patient had mastered the required step.

At baseline, both the intervention (n = 51) and control (n = 52) groups showed similar demographic and clinical characteristics. At the 3-month follow-up, inhaler technique had improved in the video-based TTG group compared with the verbal-based TTG group (93.4% vs 67%) and compared with baseline (93.4%-49.5%; P < .05).

Additionally, medication adherence improved in the video-based TTG group compared with the verbal TTG group from 88.2% to 61.5% and to baseline (88.2% to 66.7%; P < .05). Disease control also improved in the intervention group from 35.3% at baseline to 54.9%. Lastly, asthma patients in the intervention group had significantly higher QOL scores at follow-up compared with baseline, with improved scores identified for COPD patients compared with controls (P < .05).

The researchers acknowledge some limitations to this study, including losing some patients at follow-up and patients not wanting to visit the study site due to the COVID-19 pandemic. Furthermore, the study was unable to achieve a balance in the number of patients and included more asthmatic patients than COPD patients.

Despite these limitations, the researchers believe this study shows promising results of how video-based TTG intervention may improve inhaler technique, disease control, QOL, and medication adherence among patients with COPD or asthma.

“The long-term effect on the study secondary outcomes is suggested to be directly related to the improvement in the inhaler technique mastery and to the reinforcing nature of the videos, easily accessible by the patients at any time,” concluded the researchers.


Al-Kharouf MS, Abdeljalil MH, Obeidat NM, Oweidat KA, Awwad O. Video-based teach-to-goal intervention on inhaler technique on adults with asthma and COPD: A randomized controlled trial. PLoS One. 2023;18(6):e0286870. Published 2023 Jun 9. doi:10.1371/journal.pone.0286870

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