Inadequate inhaler technique, an everlasting problem, is associated with poor disease control - A cross sectional study

Adv Respir Med. 2019;87(4):217-225. doi: 10.5603/ARM.a2019.0021.

Abstract

Introduction: Dry powder inhalers (DPI) have been in use in the treatment of chronic respiratory diseases for decades. DPIs require proper inhaler technique to ensure appropriate dose delivery to the lungs which in turn provides disease control and hence reduces the economic burden due to frequent acute attacks and hospital visits. Inadequate inhaler technique remains an everlasting problem among patients with chronic respiratory disease. Hence the aim is to assess the inhaler technique in patients using DPI and to determine the factors associated with inhaler technique.

Material and methods: A cross-sectional study was conducted and 385 patients with asthma or chronic obstructive pulmonary disease (COPD) were recruited. Patient-related and disease-related factors were noted. Severity of the disease were assessed using asthma control test/COPD assessment test questionnaire and spirometer. The investigator assessed the inhaler technique of the patient against standard checklist.

Results: Nearly 46.2% of the patients performed incorrect inhaler technique. Multivariate analysis showed factors like young age [Odd's ratio (OR) 4.13, CI 1.31-17.8], well controlled disease (OR 2, CI 1.1-3.65), and the patients who learnt the technique from a medical personnel (OR 3.67, CI 1.46-9.24) had better inhaler technique.

Conclusion: This study shows that the proper use of inhaler is still an unattained goal and significance of correct use has to be reiterated.

Keywords: adults; asthma; chronic obstructive pulmonary disease; dry powder inhaler; spirometry.

MeSH terms

  • Administration, Inhalation
  • Adult
  • Asthma / drug therapy
  • Bronchodilator Agents / therapeutic use*
  • Cross-Sectional Studies
  • Dry Powder Inhalers / methods*
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Education as Topic / methods*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*

Substances

  • Bronchodilator Agents