Education intervention
Once the initial questionnaire was completed and after having evaluated IT, the education intervention was performed. A 15-minute course about IT was imparted, which included a verbal explanation of IT essential ideas supported by multimedia (power-point presentation). Emphasis was given to the importance of adapting IT to patients’ age and abilities. Subsequently, a demonstration of MDI IT was performed. IT with a space chamber and facemask was demonstrated using a mannequin, while IT with a space chamber and mouthpiece was performed by one of the main investigators, exemplifying how to perform each step.
Phase 2 (P2) and phase 3 (P3): Reevaluation.
The impact of the education intervention was evaluated one month (phase 2) and 6 months (phase 3) after the education intervention. Firstly, participants filled-in the same questionnaire as in P1. Three additional questions were included: perceived satisfaction and usefulness of the education intervention (in a score 0 to 10), as well as if the intervention had entailed a change in daily practice. Secondly, subjects demonstrated IT using a mannequin for IT with facemask and space chamber and doing it themselves for IT with only space chamber with mouthpiece). IT was evaluated using the same checklists as in P1. We considered an effective educational intervention if an upgrade of 1 point in the total score of the IT was achieved with respect to the score in P1.