Inhaler use technique
Information paper for health professionals
Inhaler technique in adults with asthma or COPD
Incorrect technique when taking inhaled medications frequently prevents patients with asthma or chronic obstructive pulmonary disease (COPD) from receiving the maximal benefit from their medications. Recent studies confirm that:
• regardless of the type of inhaler device prescribed, patients are unlikely to use inhalers correctly unless they receive clear instruction, including a physical demonstration
• the risk of misusing inhalers is particularly high in older and more debilitated patients
• brief verbal instruction on correct technique, with a physical demonstration, is effective when repeated over time and can improve clinical outcomes.
Watch demonstrations online at www.national asthma.org.au
inhaler technique results in loss of bronchodilator effect.16
Among patients using standard pMDIs without a spacer, failure to coordinate inspiration with actuation has been shown to result in reduced lung deposition of medication.17
Incorrect use of pMDIs for inhaled corticosteroids (ICS) has been associated with increased reliever use, increased use of emergency medical services, worsening asthma and higher rates of asthma instability as assessed by a general practitioner. These outcomes are most pronounced among patients with poor inspiration–actuation coordination.14
Inefficient technique with DPIs may also lead to insufficient drug delivery and therefore insufficient lung deposition.3
What was already known on this topic?
Incorrect inhaler technique is common A large proportion of patients prescribed inhaled medications do not use their inhalers correctly. Overall, up to 90% of patients show incorrect technique in clinical studies with either standard pressurised metered dose inhalers (pMDIs)1,2 or dry-powder inhalers (DPIs) such as Accuhaler, Aerolizer,
HandiHaler and Turbuhaler.3 Although these newer inhalers were designed to
Inhaler technique in adults with asthma or COPD
Incorrect technique when taking inhaled medications frequently prevents patients with asthma or chronic obstructive pulmonary disease (COPD) from receiving the maximal benefit from their medications. Recent studies confirm that:
• regardless of the type of inhaler device prescribed, patients are unlikely to use inhalers correctly unless they receive clear instruction, including a physical demonstration
• the risk of misusing inhalers is particularly high in older and more debilitated patients
• brief verbal instruction on correct technique, with a physical demonstration, is effective when repeated over time and can improve clinical outcomes.
Watch demonstrations online at www.national asthma.org.au
inhaler technique results in loss of bronchodilator effect.16
Among patients using standard pMDIs without a spacer, failure to coordinate inspiration with actuation has been shown to result in reduced lung deposition of medication.17
Incorrect use of pMDIs for inhaled corticosteroids (ICS) has been associated with increased reliever use, increased use of emergency medical services, worsening asthma and higher rates of asthma instability as assessed by a general practitioner. These outcomes are most pronounced among patients with poor inspiration–actuation coordination.14
Inefficient technique with DPIs may also lead to insufficient drug delivery and therefore insufficient lung deposition.3
What was already known on this topic?
Incorrect inhaler technique is common A large proportion of patients prescribed inhaled medications do not use their inhalers correctly. Overall, up to 90% of patients show incorrect technique in clinical studies with either standard pressurised metered dose inhalers (pMDIs)1,2 or dry-powder inhalers (DPIs) such as Accuhaler, Aerolizer,
HandiHaler and Turbuhaler.3 Although these newer inhalers were designed to
References: Australia, 2006.