Quality use of asthma medications in people with special needs

This thesis focuses on a vulnerable group of people with asthma that have to date been ignored in the literature i.e. individuals with intellectual disability (ID) who use inhalers. Based on their cognitive, and sometimes physical and sensory impairments, people with ID are a subgroup of people with asthma who potentially have special needs, require additional support and are at increased risk of inhaler misuse. Through a multifaceted exploration into several aspects of their care, their environment and their specific needs, strategies to assist people with asthma who also have ID are identified. Key research areas considered are the health care context of individuals with ID and respiratory illness, the perceptions of their caregivers around asthma medication management and the knowledge and skills of individuals with ID regarding asthma medication self-management, including inhaler technique mastery. A qualitative examination of the inhaler technique training is triangulated with established quantitative techniques to give the first insights into how individuals with mild levels of ID actually use their inhalers. Finally the thesis examines the knowledge and skills of healthcare providers caring for an “at risk” population, including individuals with ID. Future research directions are outlined, and respiratory care recommendations are proposed.