Paper Title
To What Extent Might Speciality Training in Inhaler Technique for Healthcare Professionals or Access to Regular Asthma Reviews and Follow ups Influence the Proportion of Patients Who are Being Properly Trained and Assessed on Appropriate Inhaler Technique?

Abstract
BACKGROUND/AIMS: Poor inhaler technique has been linked to poor Asthma management1. Thus, there is a need to identify factors that contribute to improper inhaler technique. This study investigates the association between the level of speciality training of clinicians and the access to Asthma clinics on inhaler technique in patients registered at Stanley Health centre. METHODS: This study follows a retrospective and service evaluation design. Once ethical approval was granted, questionnaires were distributed to patients with Asthma at Stanley Health Centre. The questionnaires investigated influential factors, including patient demographics, education background, awareness on inhaler technique and number of Asthma attacks in order to identify critical errors. Patients were then formally assessed on inhaler technique by their respective clinician. RESULTS: 64.3% of patients from the study population observed correct inhaler technique: 83.3% of these patients were seen by a specialist Nurse who was adequately trained in Asthma management. The remaining 16.6% of these patients were seen by other clinician’s void of specialist Asthma training. Patients with access to Asthma clinics accounted for 77.7% of those who demonstrated correct inhaler technique. However, 70% of the 35.7% patients who failed to meet the criteria of correct inhaler technique were seen by healthcare professionals who did not have additional training in Asthma management. CONCLUSIONS: Patients who were seen by specialist trained Asthma nurses with regular access to Asthma clinics were most likely to acquire proper inhaler usage. There is a correlation between inhaler technique and Asthma control, hospital admissions and quality of life (QOL). Thus, Asthma management should target inhaler training to reduce key critical errors.