Inhaler technique – A time to re-educate patients?

Background: The benefit of inhaled therapy depends on adequate airway drug deposition, and it is essential that patients are educated in inhaler use, and technique assessed at least once every 15 months 1 . Aim: This study aims to evaluate inhaler technique in patients, with a view to implementing change if needed. Methods : Inpatients with no significant cognitive impairment, who had been prescribed inhalers for any respiratory condition, were randomly selected. Inhaler technique was assessed by a chest physician, using the patients9 own inhalers. A scoring system 2 evaluating each domain (1 point for each) – preparation, expiration, inspiration and breath holding was used. Results : 81 (42% male) patients (mean age 73 ± 13 years) using 121 devices were evaluated. 75% had previously been shown how to use the device (family physician 51%, nurse 26%, pharmacist 8%, hospital doctor 5%). Table 1 summarises the main results. MDI9s (x 2 :8.5; p=0.03) and MDI9s plus spacer (x 2 :12.17; p=0.02) were most likely to be used adequately or well. Conclusions : Many patients have inadequate inhaler technique. There is a need to review drug delivery devices at every given opportunity to ensure the patient is using the correct drug and device effectively. References: 1.The NHS Information Centre for health and social care. National Quality and Outcomes Framework Achievement Data 2008/09 , September 2009 2. Hilton S. Br J Gen Pract. 1990 Dec;40(341):505-6.