Developing a Virtual Teach-To-Goal Inhaler Technique Learning Module: A Mixed Methods Approach

J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1728-1736. doi: 10.1016/j.jaip.2017.04.032. Epub 2017 Jun 7.


Background: Most hospitalized patients with asthma or chronic obstructive pulmonary disease misuse respiratory inhalers. An in-person educational strategy, teach-to-goal (TTG), improves inpatients' inhaler technique.

Objective: To develop an effective, portable education intervention that remains accessible to hospitalized patients postdischarge for reinforcement of proper inhaler technique.

Methods: A mixed methods approach at an urban academic hospital was used to iteratively develop, modify, and test a virtual teach-to-goal (V-TTG) educational intervention using patient end-user feedback. A survey examined access and willingness to use technology for self-management education. Focus groups evaluated patients' feedback on access, functionality, and quality of V-TTG.

Results: Forty-eight participants completed the survey, with most reporting having Internet access; 77% used the Internet at home and 82% used the Internet at least once every few weeks. More than 80% reported that they were somewhat or very likely to use V-TTG to gain skills to improve their health. Most participants reported smartphone access (73%); half owned laptop computers (52%). Participants with asthma versus chronic obstructive pulmonary disease were more likely to own a smartphone, have a data plan, and have daily Internet use (P < .05). Nine focus groups (n = 25) identified themes for each domain: access-platform and delivery, Internet access, and technological literacy; functionality-usefulness, content, and teaching strategy; and quality-clarity, ease of use, length, and likability.

Conclusions: V-TTG is a promising educational tool for improving patients' inhaler technique, iteratively developed and refined with patient input. Patients in our urban, academic hospital overwhelmingly reported access to platforms and willingness to use V-TTG for health education.

Keywords: Asthma; Patient education; Pulmonary disease; Self-care; chronic obstructive.

MeSH terms

  • Adult
  • Asthma / rehabilitation*
  • Female
  • Humans
  • Inhalation
  • Inpatients
  • Internet
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers
  • Patient Education as Topic / methods*
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Software
  • United States