Pharmacist-Led Inhaler Technique Education and Asthma Outcomes in Rural Jordan: A Pre–Post Interventional Study

Abstract

Background: Correct use of inhaler devices is essential for effective asthma management. Patients in rural areas often face barriers to accessing structured asthma education, which may contribute to poor disease control and high reliever use. Pharmacists are well placed to provide inhaler technique education in these settings.

Objectives: To evaluate the effect of pharmacist-delivered inhaler technique education on
asthma patients living in rural Jordan, specifically on:
1. inhaler technique performance,
2. Asthma Control Test (ACT) score,
3. forced expiratory volume in 1 second (FEV₁%), and
4. reliever inhaler use (puffs/day).

Methods: A pre–post interventional study was conducted over 6 months (February–July 2017) in rural regions of Jordan. Asthma patients attending respiratory clinics and using a metered dose inhaler (MDI) or turbuhaler (TH) as controller therapy were randomly
recruited. Baseline data included demographics, inhaler technique (assessed using validated checklists), ACT score, FEV₁% (spirometry), and reliever use (puffs/day). Patients then received structured, pharmacist-led inhaler technique education using a “show and tell” plus
return demonstration approach. The same measures were reassessed 3 months later. Statistical analyses included paired comparisons, correlation analyses, and multiple linear regression with change in ACT score as the main outcome.