Authors (including presenting author) :
Mak CMS(1), Yuen KY(1), Wong YP(1), Mak PT(1) Chow KWS(2), Fung YY(2), Mak YF(2), Sin LK(2)
Affiliation :
(1) Occupational Therapy Department, Grantham Hospital (2) Tuberculosis and Chest Unit, Grantham Hospital
Keyword 2: :
VannAir Inhaler
Keyword 3: :
Occupational Therapy
Keyword 4: :
Pulmonary Disease
Keyword 5: :
Assistive device
Introduction :
VannAir, a pressurized metered dose inhaler (pMDI) used to treat the symptoms of lung disease including Asthma, and COPD. Activation of the inhaler requires firm manual pressure to release the aerosolized medication by pressing the bottle, with spraying and inhaling the medicine simultaneously. Consequently, adequate fine motor skills such as pinch and grip strength, finger dexterity and cognitive abilities also possess important components in an effective drug activation. Patients who had difficulties using the physical device of the prescribed inhalers often missed the medication or had poor inhaler technique. As a result, reducing the effectiveness of medication and leading to poorer disease control and more frequent exacerbations. In addition, the higher patient satisfaction with the inhaler, the higher adherence to the inhalation therapy was associated. This study aims to design and investigate the use of 3D-printed hand function assistive devices in enhancing overall independence and disease self-management in patients in need.
Objectives :
1. To promote ease of use of device to a simpler and smoother inhaler process. 2. To enhance the level of independence, satisfaction of patient in using inhaler to increase treatment adherence and medication compliance. 3. To facilitate better eye-hand coordination for ensuring proper inhaler technique with the aim of promoting disease management and health outcome.
Methodology :
Inclusion Criteria: Participants in this study were individuals with aged 18 years or older with a confirmed diagnosis of pulmonary disease, who were physically stable and capable of self-administering the VannAir inhaler. Additionally, these patients had to experience difficulties in manipulating the VannAir inhaler or in addition to MDI spacer with various hand function issues such as problems with finger joints, reduced grip and pinch strength, impaired coordination or altered sensation. Exclusion Criteria: Patients were excluded from the study if they presented with confusion, uncooperativeness, or inability to follow instructions. Program Pathway: The intervention pathway consisted of four primary steps. Initially, eligible patients were preliminarily screened and referred by nursing staff. Subsequently, an assessment and intervention plan was conducted by an Occupational Therapist (OT). First, hand function assessment and training included evaluations of grip strength, pinch strength ( tip-to-tip and lateral pinch), sensation, coordination and direct observation of inhaler use during task performance. Second, prescription and practice of 3D assistive device will be proceeded following the assessment, practice sessions were also conducted to familiarize participants with its use. For outcome measurement, Feeling of Satisfaction with Inhaler(FSI-10) is a 10-question tool assessing patient satisfaction with their inhaler device, covering ease of use, comfort, portability, and usability through a 5-point scale. Adherence to inhaler was evaluated with the Test of Adherence to Inhalers(TAI-12), a 10 questions that patient self-administered (10-item TAI), in addition to another 2 questions for the healthcare professional caring for them. Additionally, a short questionnaire was administered to the nursing staff on effectiveness on improving inhaler education and patient's independence on using inhaler. After the intervention and assessment, nurses continued with routine inhaler technique education. At last, a post intervention assessments was conducted by OT to evaluate the effectiveness of the program.
Result & Outcome :
There were five patients referred from TBCU ward and Day Center to this program since August 2025. A total of five patients with aged 64-76 were screened and assessed, three patients met the criteria and underwent our program with initial assessment, training session, review and post assessment completed. Two patients were able to self-administered VannAir with spacer with the implementation of the 3D printing assistive device. For outcome measures, mean score of FSI-10 increased from 25 to 46 (out of 50) while TAI-12 increased from 45 to 50 (out of 54). Nurse assessed effectiveness in improving inhaler education and patient's independence achieved a full score of 5 out of 5 on the questionnaire. These findings indicate improvements in both objective (adherence and actual performance) and subjective (satisfaction and confidence) measures. The intervention enhanced patient compliance, adherence, and satisfaction with inhaler use, promoted greater independence in actual inhaler performance and increased confidence in proper inhaler technique. It also facilitated inhaler education by nursing staff. The pilot OT VannAir 3D printing assistive device program demonstrated substantial benefits for both patients and nursing staff. It enhanced patient's independence, confidence and adherence to proper inhaler technique while facilitating the educational process for inhaler use. This program also established a foundation for integrating 3D printing assistive device into clinical practice. In the future, we would strive to investigate the use of 3D printing and other new technology to further enhance the service quality and patients care in need. Further data study and analysis would be accumulated to our data set to enable robustness of this program and will continue to be carried on in our clinical practice.
